Registry details
Type
Individual
Primary specialty
Orthopaedic Surgery
Enumerated
May 12, 2006
License(s)
01037487A (IN), 41335 (IA), 10090 (SD), 036172356 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 900 W TEMPLE AVE STE 2500 | Effingham, IL 62401-2121 | 217-540-2350 |
| LOCATION | 900 W TEMPLE AVE STE 2500 | Effingham, IL 62401-2121 | 217-540-2350 |
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