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Organization
BELLA MEDICA LASER CENTER
Active
Organization
BELLA MEDICA LASER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS JAY RADER CLT (DIR. OF OPERATIONS)
(815) 344-0303
Entity
Organization
Contact information
Practice address
5435 BULL VALLEY RD, SUITE#118, MCHENRY, IL 60050-7434
(815) 344-0303
Mailing address
5435 BULL VALLEY RD, SUITE#118, MCHENRY, IL 60050-7434
(815) 344-0303
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
NA
IL
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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