Organization
MARION VA HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE NICOLE BELTZ CRT (RESPIRATORY THERAPIST)
(618) 997-5311
Entity
Organization
Contact information
Practice address
705 PAWNEE DR, DU QUOIN, IL 62832-2557
(618) 997-5311
Mailing address
705 PAWNEE DR, DU QUOIN, IL 62832-2557
(618) 997-5311
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
194007504
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
194007504
CRT
IL
Enumeration date
06/27/2012
Last updated
06/27/2012
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