NPI | 1194967356 |
---|---|
Entity Type | Organization |
Authorized Contact | INDIGO BUTT Billing Department 217-872-1003 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178006034) |
Enumeration Date | 2009-04-01 |
Last Update Date | 2009-04-01 |