Organization
MUSCULOSKELETAL SURGERY CENTER, LLC
Active
Other names
Great Plains, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANET E SMITH (CHIEF OPERATING OFFICER)
(309) 676-5546
Entity
Organization
Contact information
Practice address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 676-5045
Mailing address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
(309) 676-5045
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
7003146
IL
Other
Enumeration date
09/11/2009
Last updated
09/11/2009
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