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Organization

THE BRIDGE CLINIC OF ROCKOFRD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ANNETTE OLIN M.D. (MEDICAL DIRECTOR)
(815) 494-1594
Entity
Organization

Contact information

Practice address
318 N CHURCH ST, ROCKFORD, IL 61101-1006
(815) 494-1594
Mailing address
PO BOX 16024, LOVES PARK, IL 61132-6024
(815) 494-1594
(866) 506-0931

Taxonomy

Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
261QP2300X
Primary Care Clinic/Center

Other

Enumeration date
08/27/2015
Last updated
08/27/2015
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