LARRY J KOTEWA

PEORIA, IL
NPI1942278130
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IL  209000656)
Enumeration Date2006-03-14
Last Update Date2007-07-08
Business Address
Mr. LARRY J KOTEWA CRNA
124 W WHITEHALL CT
PEORIA, IL 61614-3032
Phone number: 309-691-2607
Mailing Address
Mr. LARRY J KOTEWA CRNA
124 W WHITEHALL CT
PEORIA, IL 61614-3032
Phone number: 309-691-2607
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