Organization
TPS FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANDON PRYOR MD (PROVIDER)
(815) 977-4403
Entity
Organization
Contact information
Practice address
5995 SPRING CREEK RD, ROCKFORD, IL 61114-6481
(815) 977-4403
Mailing address
5995 SPRING CREEK RD, ROCKFORD, IL 61114-6481
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/29/2020
Last updated
04/29/2020
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