Individual
TIM CARRASCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 827-6026
Mailing address
1003 MARTIN LUTHER KING DR, BLOOMINGTON, IL 61701-1429
(309) 827-6026
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/14/2007
Last updated
07/08/2007
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