Organization
REJUV PEORIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN CHRISTOPHER SNIDER CNP (OWNER)
(309) 678-4243
Entity
Organization
Contact information
Practice address
501 N MORTON AVE, MORTON, IL 61550-1526
(309) 263-4673
(309) 263-4611
Mailing address
501 N MORTON AVE, MORTON, IL 61550-1526
(309) 263-4673
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
IL036086752
IL
Other
Enumeration date
05/18/2012
Last updated
05/18/2012
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