Organization
VICKI TILTON, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI L TILTON (PRESIDENT/OWNER)
(309) 242-4951
Entity
Organization
Contact information
Practice address
200 W MONROE ST, STE 309, BLOOMINGTON, IL 61701-3997
(309) 242-4951
Mailing address
200 W MONROE ST, STE 309, BLOOMINGTON, IL 61701-3997
(309) 242-4951
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/07/2008
Last updated
01/07/2008
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