Organization
NEUROPSYCHOLOGY CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY P KURTH (OFFICE MANAGER)
(309) 686-9005
Entity
Organization
Contact information
Practice address
3100 N DRIES LN, STE 303, PEORIA, IL 61604-1265
(309) 686-9005
(309) 686-9020
Mailing address
3100 N DRIES LN, STE 303, PEORIA, IL 61604-1265
(309) 686-9005
(309) 686-9020
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
071004929
IL
Other
Enumeration date
12/04/2007
Last updated
05/20/2013
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