Individual
MARY KRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 842-3633
(815) 844-6309
Mailing address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9774
(815) 842-3633
(815) 844-6309
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041127668/209001388
IL
Other
Enumeration date
10/01/2006
Last updated
07/08/2007
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