Organization
A T & G P DEVASGUNAWARDHANE MD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAT GRAY (OFFICE MANAGER)
(815) 694-2381
Entity
Organization
Contact information
Practice address
102 COMMERCE DR, CLIFTON, IL 60927-9501
(815) 694-2381
Mailing address
102 COMMERCE DR, CLIFTON, IL 60927-9501
(815) 694-2381
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/14/2007
Last updated
08/05/2010
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