Organization
JERSEY COUNTY ANESTHESIA GROUP LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY DUANE RAWLINGS CRNA (PRESIDENT)
(618) 498-9014
Entity
Organization
Contact information
Practice address
400 MAPLE SUMMIT RD, JERSEYVILLE, IL 62052-2028
(618) 498-9014
(618) 498-9014
Mailing address
301 HAWBROOK PL, JERSEYVILLE, IL 62052-1018
(618) 498-9014
(618) 498-9014
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
060.008358
IL
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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