Individual
DR. MARY ANN FENSTERBUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
202 W 2ND ST, GENESEO, IL 61254-1322
(309) 944-3208
Mailing address
202 W 2ND ST, GENESEO, IL 61254-1322
(309) 944-3208
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03708465
BCBSIL
IL
Enumeration date
12/15/2006
Last updated
07/08/2007
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