Individual
EDWARD COCHRAN NEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
212 S LOGAN AVE, MATTOON, IL 61938-4595
(217) 235-3126
Mailing address
500 WABASH AVE, MATTOON, IL 61938-4422
(217) 234-4213
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
051029224
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
40022346057
DRIVERS LICENSE
IL
Enumeration date
09/20/2011
Last updated
09/20/2011
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