Organization
ABUNDANT LIFE MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS GERRY A KLINEFELTER (OFFICE MANAGER)
(217) 824-2524
Entity
Organization
Contact information
Practice address
1141 N CHENEY ST, TAYLORVILLE, IL 62568-2741
(217) 824-2524
(217) 824-2588
Mailing address
1141 N CHENEY ST, TAYLORVILLE, IL 62568-2741
(217) 824-2524
(217) 824-2588
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
—
—
Other
Enumeration date
08/14/2006
Last updated
01/15/2009
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