Individual
MELINDA A MAUL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
208 WASHINGTON ST, CONGERVILLE, IL 61729-0074
(309) 258-7701
Mailing address
208 WASHINGTON ST, CONGERVILLE, IL 61729-0074
(309) 258-7701
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
160005191
IL
Other
Enumeration date
09/10/2010
Last updated
09/10/2010
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