Organization
LICK CREEK SCHOOL DIST 16
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY WHITLEDGE (SUPERINTENDENT)
(618) 833-2545
Entity
Organization
Contact information
Practice address
7355 LICK CREEK RD, BUNCOMBE, IL 62912-3016
(618) 833-2545
(618) 833-3201
Mailing address
7355 LICK CREEK RD, BUNCOMBE, IL 62912-3016
(618) 833-2545
(618) 833-3201
Taxonomy
Speciality
Code
Description
License number
State
261QS1000X
Student Health Clinic/Center
Primary
—
IL
Other
Enumeration date
04/08/2008
Last updated
04/20/2008
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