Individual
DIANA MORRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MT
Contact information
Practice address
635 W US HIGHWAY 50, O FALLON, IL 62269-1941
(618) 977-4855
Mailing address
635 W US HIGHWAY 50, O FALLON, IL 62269-1941
(618) 977-4855
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
227.000506
IL
Other
Enumeration date
05/27/2010
Last updated
05/27/2010
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