Individual
KHIN AYE HTWE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFA
Contact information
Practice address
3002 GILL ST, BLOOMINGTON, IL 61704-3438
(847) 204-6943
Mailing address
1214 BRENTWOOD CT, NORMAL, IL 61761-1809
(847) 204-6943
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
IL
Other
Enumeration date
11/19/2007
Last updated
11/19/2007
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