Organization
MIND BODY SPIRIT CARE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CATHERINE DEANNE MARSHALL APRN-BC (PRESIDENT-OWNER/PROVIDER)
(618) 624-2788
Entity
Organization
Contact information
Practice address
9640 MALLARD DR, MASCOUTAH, IL 62258-2762
(618) 960-8796
Mailing address
215 N BROADWAY AVE, SALEM, IL 62881-1511
(618) 960-8796
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
IL
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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