Individual
LEA ANN GOLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
108 W MARKET ST, BLOOMINGTON, IL 61701-3918
(309) 827-5351
(309) 829-6808
Mailing address
108 W MARKET ST, BLOOMINGTON, IL 61701-3918
(309) 827-5351
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041393447
IL
Other
Enumeration date
12/01/2011
Last updated
03/17/2014
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