Individual
IVY MEGAN PAIGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
1604 VISA DR, STE. 2, NORMAL, IL 61761-2195
(309) 846-4716
(309) 454-7348
Mailing address
1604 VISA DR, STE. 2, NORMAL, IL 61761-2195
(309) 846-4716
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
08/14/2013
Last updated
08/14/2013
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