Organization
MIDWEST EAR NOSE & THROAT CLINIC, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID MANN M.D. (OWNER)
(618) 993-0307
Entity
Organization
Contact information
Practice address
3316 PATRIOT CT, HERRIN, IL 62948-3782
(618) 993-0307
(618) 993-0807
Mailing address
3316 PATRIOT CT, HERRIN, IL 62948-3782
(618) 993-0307
(618) 993-0807
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
IL
Other
Enumeration date
05/25/2007
Last updated
01/22/2010
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