Organization
DEPARTMENT OF VETERANS AFFAIRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES W. ROSEBOROUGH (MEDICAL CENTER DIRECTOR)
(618) 997-5311
Entity
Organization
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 993-8149
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 993-8149
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
071.007669
IL
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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