Individual
MRS. ANITA JEAN REGENOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 661-5190
(309) 661-7892
Mailing address
10405 E 1700 NORTH RD, PONTIAC, IL 61764-3422
(815) 743-5785
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
IL
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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