Organization
PENNY ATTAWAY
Active
Other names
Medical Servics Unlimited
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PENNY ATTAWAY (DNP)
(618) 971-1440
Entity
Organization
Contact information
Practice address
1404 N 5TH ST, VANDALIA, IL 62471-1039
(618) 283-2000
(618) 283-2002
Mailing address
1404 N 5TH ST, VANDALIA, IL 62471-1039
(618) 283-2000
(618) 283-2002
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
209001693
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L040233
TRICARE
IL
Enumeration date
03/26/2007
Last updated
12/20/2016
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