Individual
NANCY WIDMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CST
Contact information
Practice address
7309 N KNOXVILLE AVE STE 2, PEORIA, IL 61614-2086
(309) 692-9210
Mailing address
7309 N KNOXVILLE AVE STE 2, PEORIA, IL 61614-2086
(309) 692-9210
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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