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1942616578
MANASA KANDULA
PEORIA, IL
NPI
1942616578
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 125064713)
Enumeration Date
2014-07-02
Last Update Date
2014-07-02
Business Address
-- MANASA KANDULA
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-6384
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Mailing Address
-- MANASA KANDULA
530 NE GLEN OAK AVE
PEORIA, IL 61637-0001
Phone number: 309-655-2730
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