Individual
LISA HOUSE/APARTMENT BYARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2471 CENTENNIAL DR, WASHINGTON, IL 61571-1066
(309) 717-9197
Mailing address
605 N MAIN ST, MORTON, IL 61550-1635
(309) 256-7651
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
041.459210
IL
Other
Enumeration date
10/26/2018
Last updated
10/26/2018
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