Organization
REJUV CHAMPAIGN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN CHRISTOPHER SNIDER CNP (OWNER)
(309) 678-4243
Entity
Organization
Contact information
Practice address
606 NORTH COUNTY FAIR DRIVE, A, CHAMPAIGN, IL 61820
(217) 607-0762
Mailing address
405 N HERSHEY RD, BLOOMINGTON, IL 61704-3527
(309) 662-3002
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
209005824
IL
Other
Enumeration date
05/21/2012
Last updated
05/21/2012
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