Individual
CHRISTOPHER DANBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1184 W MAIN ST, GRISWOLD PHYSICAL EDUCATION CENTER, DECATUR, IL 62522-2039
(845) 988-6028
Mailing address
1184 W MAIN ST, GRISWOLD PHYSICAL EDUCATION CENTER, DECATUR, IL 62522-2039
(845) 988-6028
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
096.003536
IL
Other
Enumeration date
07/02/2015
Last updated
07/02/2015
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