Individual
THOMAS FRANK MYERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
6901 N GALENA RD, PEORIA, IL 61614-3193
(309) 689-2180
Mailing address
6901 GALENA RD, PEORIA, IL 61614-3193
(309) 689-2180
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041339152
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123456789
—
IL
Enumeration date
06/25/2021
Last updated
06/25/2021
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