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Individual

IMANOL SALAZAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
1510 W OTTAWA RD, PAXTON, IL 60957-4090
(217) 379-4302
(217) 817-0379
Mailing address
PO BOX 162, PAXTON, IL 60957-0162
(217) 379-4302
(217) 817-0379

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/05/2024
Last updated
06/05/2024
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