| NPI | 1225289861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | J. TRAVIS DOWELL Vice President Hcna And Operations 217-788-3342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2008-10-01 |
| Last Update Date | 2008-10-01 |