Individual
ALLYSON MARIE TECKENBROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
11531 SUNDERLAND RD, MARION, IL 62959-8274
(618) 964-5139
Mailing address
11531 SUNDERLAND RD, MARION, IL 62959-8274
(618) 964-5139
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.130444
IL
Other
Enumeration date
12/03/2021
Last updated
12/03/2021
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