Individual
RUTH E TOWNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LDN, CDE
Contact information
Practice address
8600 NORTH ROUTE 91, PEORIA, IL 61615
(309) 624-3250
(309) 624-3257
Mailing address
8600 NORTH ROUTE 91, PEORIA, IL 61615
(309) 624-3250
(309) 624-3257
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
164004417
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
809840
MEDICARE GROUP PTAN
IL
Enumeration date
09/16/2008
Last updated
11/20/2008
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