Individual
MRS. SARAH ELIZABETH INTRAVAIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
1503 DAVIS AVE, JOHNSTON CITY, IL 62951-2022
(618) 983-5674
Taxonomy
Speciality
Code
Description
License number
State
246QM0706X
Medical Technologist
Primary
225215
IL
Other
Enumeration date
08/22/2007
Last updated
08/22/2007
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