Individual
MISS LARISA GEORGY CIATLOS-DEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4965 E LOST BRIDGE RD, DECATUR, IL 62521-5139
(217) 864-5531
(217) 864-2449
Mailing address
4965 E LOST BRIDGE RD, DECATUR, IL 62521-5139
(217) 864-5531
(217) 864-2449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036153610
IL
Other
Enumeration date
05/31/2017
Last updated
07/15/2020
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