PRINCE OSAZUWA EHIMAMIEGHO

PEORIA, IL
NPI1497499719
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL  0000000000)
Enumeration Date2022-04-22
Last Update Date2022-04-22
Business Address
PRINCE OSAZUWA EHIMAMIEGHO MD
815 MAIN ST STE C
PEORIA, IL 61602-1080
Phone number: 309-672-4977
Mailing Address
PRINCE OSAZUWA EHIMAMIEGHO MD
9466 MOURVERDE CT
ELK GROVE, CA 95624-4611
Phone number: