Individual
MR. JOHN PATRICK FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
(618) 993-7749
Mailing address
385 CEDAR POINT RD, GALATIA, IL 62935-2175
(618) 499-6727
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043.127105
IL
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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