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Individual

MRS. VICTORIA LEE LAWSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
11210 95TH ST, COAL VALLEY, IL 61240-9360
(309) 799-3161
(309) 799-5904
Mailing address
102 MAIN ST, P.O. BOX 214, OPHIEM, IL 61468-9501
(309) 629-8902

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
IL

Other

Enumeration date
10/16/2007
Last updated
10/16/2007
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