Individual
DARCIE LYNN NEOFOTIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2701 17TH ST, ROCK ISLAND, IL 61201-5351
(309) 779-2187
Mailing address
520 VALLEY VIEW DR, MOLINE, IL 61265-6152
(309) 762-3621
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
237000152
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246ZS0410X
—
IL
Enumeration date
04/09/2019
Last updated
04/09/2019
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