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1972890499
DOMICA SHANTA LIGHT
CHAMPAIGN, IL
NPI
1972890499
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251B00000X Case Management
Enumeration Date
2011-07-05
Last Update Date
2011-07-05
Business Address
-- DOMICA SHANTA LIGHT
202 W PARK AVE
CHAMPAIGN, IL 61820-3929
Phone number: 217-373-2430
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Mailing Address
-- DOMICA SHANTA LIGHT
2602 CARRELTON DR
CHAMPAIGN, IL 61821-4760
Phone number: 217-848-2262
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