| NPI | 1730230848 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN B. GARNER President 618-288-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: IL 036074997) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |