MICHAEL E LONGEVIN MDSC

PEORIA, IL
NPI1578870556
Entity TypeOrganization
Authorized ContactMICHAEL E LONGEVIN
President
309-692-5828
Organization Subpart ?No
Primary Taxonomy208800000X Urology
(Licence: IL  036-072215)
Enumeration Date2010-09-11
Last Update Date2010-09-23
Business Address
MICHAEL E LONGEVIN MDSC
5401 N KNOXVILLE AVE SUITE 112
PEORIA, IL 61614-5098
Phone number: 309-692-5828
Mailing Address
MICHAEL E LONGEVIN MDSC
5401 N KNOXVILLE AVE SUITE 112
PEORIA, IL 61614-5098
Phone number: 309-692-5828
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