| NPI | 1467570507 |
|---|---|
| Doing Business As | PROFESSIONAL PLAZA FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DENNIS PLUARD CFO 217-258-2513 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-18 |