Individual
KATHLEEN M ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
220 S CENTURY BLVD, RANTOUL, IL 61866-2309
(217) 892-8415
Mailing address
220 S CENTURY BLVD, RANTOUL, IL 61866-2309
(217) 892-8415
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051299991
IL
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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