Individual
CORY RAY AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA, DNP
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8500
(618) 288-5711
Mailing address
604 SHERMAN AVE, EDWARDSVILLE, IL 62025-2155
(314) 332-7969
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209021526
IL
Other
Enumeration date
06/28/2020
Last updated
06/28/2020
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