Individual
TASHA OAKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
104 KENWOOD CT APT 1, NORMAL, IL 61761-4707
(217) 637-0399
Mailing address
104 KENWOOD CT APT 1, NORMAL, IL 61761-4707
(217) 637-0399
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
—
—
Other
Enumeration date
10/02/2009
Last updated
10/02/2009
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