Individual
MR. ADAM MICHAEL BANGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
1900 E MAIN ST, NUTRITION AND FOOD SERVICE (120), DANVILLE, IL 61832-5100
(217) 554-5135
Mailing address
641 E 1700TH RD, BROCTON, IL 61917-8055
(217) 385-2406
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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