RANDALL S TENNIS

PEKIN, IL
NPI1174588792
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: IL  5435)
Enumeration Date2006-04-18
Last Update Date2007-07-08
Business Address
-- RANDALL S TENNIS CADC
3248 VANDEVER AVE
PEKIN, IL 61554
Phone number: 309-347-5522
Mailing Address
-- RANDALL S TENNIS CADC
3248 VANDEVER AVE
PEKIN, IL 61554
Phone number: 309-347-5522
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