101YP2500X
Bloomington, IL
Specialty
101YP2500X
Credential
LCPC RN
NPI
1902936636
1505 Eastland Dr., Bloomington, IL 61701
(309) 661-5004Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 101yp2500x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 101YP2500X