Organization
ADVANCED SURGICAL TECHNOLOGY, LLC
Active
Other names
AST Primary Care MT Vernon
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIA RENSING (OFFICE MANAGER)
(618) 899-9200
Entity
Organization
Contact information
Practice address
4200 WILLIAMSON PL STE 1A, MOUNT VERNON, IL 62864-6705
(618) 899-9195
(618) 918-7151
Mailing address
4200 WILLIAMSON PL STE 1A, MOUNT VERNON, IL 62864-6705
(618) 899-9195
(618) 918-7151
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2023
Last updated
06/30/2023
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