Individual
MISS MARY LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1150 STATE ROUTE 54 W, CLINTON, IL 61727-2148
(217) 935-9496
(217) 935-4508
Mailing address
1150 STATE ROUTE 54 W, CLINTON, IL 61727-2148
(217) 935-9496
(217) 935-4508
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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