| NPI | 1497462956 |
|---|---|
| Doing Business As | DEACONESS IL SPECIALTY 303 COMMERCIAL ST |
| Entity Type | Organization |
| Authorized Contact | KYLE DILLMAN Secretary Treasurer 812-450-7399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Enumeration Date | 2022-11-03 |
| Last Update Date | 2023-01-26 |