Organization
BELLA MEDICA LASER CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS JAY RADER CLT (DIR. OF OPERATIONS)
(815) 344-0303
Entity
Organization
Contact information
Practice address
5435 BULL VALLEY RD, SUITE#118, MCHENRY, IL 60050-7434
(815) 344-0303
Mailing address
5435 BULL VALLEY RD, SUITE#118, MCHENRY, IL 60050-7434
(815) 344-0303
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
NA
IL
Other
Enumeration date
09/08/2011
Last updated
09/08/2011
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