MICAH LEE SERVIS

SPRINGFIELD, IL
NPI1467752220
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: IL  238-000264)
Enumeration Date2010-10-27
Last Update Date2010-10-27
Business Address
-- MICAH LEE SERVIS SA-C
747 N RUTLEDGE ST 5TH FLOOR
SPRINGFIELD, IL 62702-6700
Phone number: 217-545-5878
Mailing Address
-- MICAH LEE SERVIS SA-C
PO BOX 19679
SPRINGFIELD, IL 62794-9679
Phone number: 217-545-5878
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