Organization
ESWOOD CC GRADE SCH DIST 269
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT MAYBERRY (SUPER)
(815) 393-4477
Entity
Organization
Contact information
Practice address
304 MAIN ST, LINDENWOOD, IL 61049-7700
(815) 393-4477
Mailing address
304 MAIN ST, LINDENWOOD, IL 61049-7700
(815) 393-4477
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
—
—
Other
Enumeration date
02/12/2008
Last updated
04/20/2008
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