Individual
MRS. LAURA ANNE ETCHASON II
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-8121
(217) 876-2261
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-8121
(217) 876-2261
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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