| NPI | 1801519384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JONES Consultant 217-822-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS1000X Clinic/Center Student Health |
| Additional Taxonomies | 261QF0050X Clinic/Center Family Planning, Non-Surgical |
| 261QH0100X Clinic/Center Health Service | |
| 363LS0200X Nurse Practitioner School | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |