AUGUST SUPAN

MATTOON, IL
NPI1598851040
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1041C0700X Social Worker Clinical
(Licence: IL  149-007817)
Enumeration Date2006-10-04
Last Update Date2015-08-04
Business Address
MR. AUGUST SUPAN MSW
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5700
Mailing Address
MR. AUGUST SUPAN MSW
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5700
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