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Individual

MARIE A MANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
17800 KEDZIE AVE, HAZEL CREST, IL 60429-2029
(219) 455-1180
Mailing address
2600 MARTHA ST, HIGHLAND, IN 46322-2754

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.220813
IL
163W00000X
Registered Nurse
28105968A
IN

Other

Enumeration date
05/09/2015
Last updated
05/09/2015
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