Organization
SELECT CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON LAESCH APRN (OWNER)
(309) 808-1450
Entity
Organization
Contact information
Practice address
2103 E WASHINGTON ST STE 2C, BLOOMINGTON, IL 61701-4365
(309) 808-1450
(949) 561-4829
Mailing address
2103 E WASHINGTON ST STE 2C, BLOOMINGTON, IL 61701-4365
(309) 808-1450
(949) 561-4829
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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