MIKE STAFF

CARBONDALE, IL
NPI1326104290
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: IL  085-000618)
Enumeration Date2006-12-28
Last Update Date2011-07-11
Business Address
-- MIKE STAFF PA
2601 W MAIN ST
CARBONDALE, IL 62901-1031
Phone number: 618-549-5361
Mailing Address
-- MIKE STAFF PA
PO BOX 1105
INDIANAPOLIS, IN 46206-1105
Phone number: 618-549-5361
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