Individual
SUZETTE MENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
301 NORTH MILWAUKEE ST., MARK, IL 61340
(815) 339-2609
Mailing address
301 NORTH MILWAUKEE ST. P.O. BOX 22, MARK, IL 61340
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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