Individual
STORMI T RAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
100 S MAIN ST, WEST SALEM, IL 62476-1202
(618) 395-7340
(618) 395-6020
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085007436
IL
Other
Enumeration date
09/19/2017
Last updated
11/20/2024
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