Individual
ZACHARY DANIEL STANDEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6755
(618) 463-7311
Mailing address
5516 MORO RD, MORO, IL 62067-1310
(618) 531-0517
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
209023397
IL
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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