Organization
PEORIA WEIGHTLOSS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KURTIS FREIDAG (OWNER)
(309) 966-3137
Entity
Organization
Contact information
Practice address
2426 W CORNERSTONE CT STE 100, PEORIA, IL 61614-2400
(309) 966-3137
Mailing address
2426 W CORNERSTONE CT STE 100, PEORIA, IL 61614-2400
(309) 966-3137
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/08/2013
Last updated
05/08/2013
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