Individual
ANGELA JAN REINERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2456 475TH AVE, EMDEN, IL 62635-6385
(217) 376-3142
Mailing address
2456 475TH AVE, EMDEN, IL 62635-6385
(217) 376-3142
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158720813
—
IL
Enumeration date
10/25/2010
Last updated
10/25/2010
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