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Individual

GREG A LANDIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN,RRT

Contact information

Practice address
265 SHARP RD, ANNA, IL 62906-4123
(618) 833-3878
Mailing address
265 SHARP RD, ANNA, IL 62906-4123
(618) 833-3878

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
IL
227900000X
Registered Respiratory Therapist
IL

Other

Enumeration date
08/21/2007
Last updated
08/21/2007
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