DWAIN CLARK ILLMAN

BLOOMINGTON, IN
NPI1548408057
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: IN  01027208)
Enumeration Date2009-01-22
Last Update Date2009-01-22
Business Address
-- DWAIN CLARK ILLMAN M.D.
811 W 2ND ST
BLOOMINGTON, IN 47403-2251
Phone number: 812-353-3533
Mailing Address
-- DWAIN CLARK ILLMAN M.D.
PO BOX 2568
BLOOMINGTON, IN 47402-2568
Phone number: 812-353-3533