Individual
MRS. DONNA S SHADOWENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 998-5667
Mailing address
2401 W. MAIN ST, MARION, IL 62959
(618) 997-5311
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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