Individual
MR. JENS PAUL NUESKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
505 W 4TH ST, DELAVAN, IL 61734-9688
(309) 241-7814
Mailing address
PO BOX 684, DELAVAN, IL 61734-0684
(309) 241-7814
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
160005451
IL
Other
Enumeration date
08/23/2010
Last updated
08/23/2010
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