Organization
HARRISBURG FAMILY PRACTICE LTD
Active
Other names
Primary Care Group
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE BOATRIGHT (ADMINISTRATOR)
(618) 252-8625
Entity
Organization
Contact information
Practice address
117 E CLARK ST, HARRISBURG, IL 62946-2702
(618) 252-8625
(618) 252-2540
Mailing address
117 E CLARK ST, HARRISBURG, IL 62946-2702
(618) 252-8625
(618) 252-2540
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036042756
IL
Other
Enumeration date
12/30/2005
Last updated
09/22/2011
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