Individual
TABATHA LEE JUSTICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2611 WOODLAWN RD, STERLING, IL 61081-4151
(815) 625-0013
Mailing address
1023 TEE ST, DIXON, IL 61021-3953
(815) 440-5802
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/25/2016
Last updated
10/25/2016
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