Organization
W EQUINE ESCAPE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA A. WILSON MS (OWNER/PRESIDENT)
(618) 559-1960
Entity
Organization
Contact information
Practice address
7230 STATE ROUTE 152, DU QUOIN, IL 62832-4330
(618) 559-1960
(618) 542-3353
Mailing address
7230 STATE ROUTE 152, DU QUOIN, IL 62832-4330
(618) 559-1960
(618) 542-3353
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
07/20/2011
Last updated
07/20/2011
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