Individual
MARY MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1564 S WASHINGTON ST, DU QUOIN, IL 62832-3849
(618) 724-2401
Mailing address
4241 HWY 14 W, CHRISTOPHER, IL 62822-1037
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043102312
IL
Other
Enumeration date
05/20/2022
Last updated
05/20/2022
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