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Individual

MARK FERRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RT(R)

Contact information

Practice address
702 SPRUCE ST, PANA, IL 62557-1869
(217) 825-3677
Mailing address
702 SPRUCE ST, PANA, IL 62557-1869
(217) 825-3677

Taxonomy

Speciality
Code
Description
License number
State
2471C1106X
Cardiac-Interventional Technology Radiologic Technologist
00-6456
SC
2471C1106X
Cardiac-Interventional Technology Radiologic Technologist
Primary
500501702
IL
2471C1106X
Cardiac-Interventional Technology Radiologic Technologist
RHF00097620
CA

Other

Enumeration date
10/29/2013
Last updated
10/29/2013
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