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1750069126
STACY D MEDINA
SPRINGFIELD, IL
NPI
1750069126
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IL 085009740)
Enumeration Date
2023-07-06
Last Update Date
2023-07-06
Business Address
STACY D MEDINA PA-C
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711-9252
Phone number: 217-547-9100
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Mailing Address
STACY D MEDINA PA-C
1301 S KOKE MILL RD
SPRINGFIELD, IL 62711-9252
Phone number: 217-547-9100
Copy
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