LISA JO SUWANAWONGSE

HARRISBURG, IL
NPI1629546411
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IL  209016422)
Enumeration Date2018-11-09
Last Update Date2018-11-09
Business Address
LISA JO SUWANAWONGSE FNP-BC
100 DR WARREN TUTTLE DR
HARRISBURG, IL 62946-2718
Phone number: 618-253-7671
Mailing Address
LISA JO SUWANAWONGSE FNP-BC
PO BOX 428
HARRISBURG, IL 62946-0428
Phone number: 618-253-7671
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