Individual
MR. GARY STOVER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 N 1ST ST, SPRINGFIELD, IL 62702-3778
(217) 528-7541
Mailing address
2001 W 86TH ST, INDIANAPOLIS, IN 46260-1902
(317) 338-6399
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
036156475
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
09/02/2021
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