Individual
CARLY TOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 W PARK ST, URBANA, IL 61801-2334
(217) 337-2000
Mailing address
407 ORCHARD DR, MAHOMET, IL 61853-3687
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164008276
IL
Other
Enumeration date
02/03/2021
Last updated
02/03/2021
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