Individual
MR. GEOFFREY LOREN BOISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1801 FOX DR, CHAMPAIGN, IL 61820-7236
(217) 398-8464
Mailing address
401 W SPRINGFIELD AVE, CHAMPAIGN, IL 61820-4716
(217) 398-8464
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/05/2015
Last updated
08/05/2015
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