| NPI | 1346323615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBY D WILLIAMS Administrator 618-285-6634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: IL 0000901) |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2008-11-25 |