Individual
DIANA ELIZABETH POOLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
9035 MAIN ST, WOLF LAKE, IL 62998-1057
(618) 833-8260
Mailing address
9035 MAIN ST, WOLF LAKE, IL 62998-1057
(618) 833-8260
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
194007005
IL
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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