Individual
REGAN LEIGH NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4241 HIGHWAY 14 WEST, CHRISTOPHER, IL 62822-0155
(618) 724-2436
Mailing address
PO BOX 155, CHRISTOPHER, IL 62822-0155
(618) 724-2436
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
049145486
IL
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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