Individual
LARRY W JOYCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 663-2237
Mailing address
PO BOX 9518, PEORIA, IL 61612
(877) 861-9294
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
036108154
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361081541
—
IL
Enumeration date
05/18/2006
Last updated
12/08/2010
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