Individual
LESLIE BAUER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 242-8240
Mailing address
4723 N NASON LN, BONNIE, IL 62816-4005
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.129346
IL
Other
Enumeration date
12/08/2022
Last updated
12/08/2022
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