PRAIRIE DERMATOLOGY, PLLC

BLOOMINGTON, IL
NPI1881333680
Entity TypeOrganization
Authorized ContactMICHAEL THOMAS GINNETTI
Physician Owner
309-531-1252
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
Enumeration Date2022-05-31
Last Update Date2022-11-23
Business Address
PRAIRIE DERMATOLOGY, PLLC
1015 S MERCER AVE STE GF7
BLOOMINGTON, IL 61701-7107
Phone number: 309-660-8442
Mailing Address
PRAIRIE DERMATOLOGY, PLLC
1015 S MERCER AVE STE GF7
BLOOMINGTON, IL 61701-7107
Phone number:
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