Organization
MARKET STREET MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY S. EYER FNP-BC (MEMBER)
(618) 392-2395
Entity
Organization
Contact information
Practice address
117 E MARKET ST, OLNEY, IL 62450-2241
(618) 392-1301
Mailing address
117 E MARKET ST, OLNEY, IL 62450-2241
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
209012101
IL
Other
Enumeration date
11/21/2014
Last updated
11/21/2014
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