Organization
JUSTIN R. AHLMAN, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN R AHLMAN M.D. (OWNER)
(309) 264-6124
Entity
Organization
Contact information
Practice address
3322 W WILLOW KNOLLS DR, PEORIA, IL 61614-8148
(309) 264-6124
Mailing address
PO BOX 3092, PEORIA, IL 61612-3092
(309) 264-6124
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036113723
IL
207LP2900X
Pain Medicine (Anesthesiology) Physician
036113723
IL
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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