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1306847900
OTIS GEORGE ALLEN
BLOOMINGTON, IL
NPI
1306847900
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208200000X Plastic Surgery
(Licence: IL 036064804)
Enumeration Date
2005-08-03
Last Update Date
2016-08-17
Business Address
Dr. OTIS GEORGE ALLEN M.D.
1215 HOLIDAY DR
BLOOMINGTON, IL 61704-2214
Phone number: 309-827-3881
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Mailing Address
Dr. OTIS GEORGE ALLEN M.D.
53 PRENZLER DR
BLOOMINGTON, IL 61704-1299
Phone number: 309-287-8049
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