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Individual

MRS. LORI LEE SPICER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
202 W PARK AVE, CHAMPAIGN, IL 61820-3929
(217) 373-2430
Mailing address
13 VALERA CT, MONTICELLO, IL 61856-2156

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043046465
IL

Other

Enumeration date
11/07/2008
Last updated
11/07/2008
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