Individual
MARY LEEZER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
513 HAMPSHIRE ST, QUINCY, IL 62301-2930
(217) 430-7041
Mailing address
513 HAMPSHIRE ST, QUINCY, IL 62301-2930
(217) 430-7041
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.070358
IL
Other
Enumeration date
12/01/2016
Last updated
12/01/2016
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