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Individual

DR. CLARK B RIANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 647-6504
Mailing address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 647-6504

Taxonomy

Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
36067263
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
36067263
IL
Enumeration date
07/29/2005
Last updated
12/04/2009
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