Organization
GOWIN ENTERPRISES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESA SUZANNE GOWIN (PRESIDENT)
(217) 234-3003
Entity
Organization
Contact information
Practice address
300 LERNA RD S, MATTOON, IL 61938-9389
(217) 234-3003
(217) 234-3081
Mailing address
6484 N COUNTY ROAD 1320E, CHARLESTON, IL 61920-7952
(217) 345-9415
(217) 345-9415
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
5103061
IL
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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