Organization · Type 2 NPI
Mind Body Spirit Care Clinic Inc
General Practice Physician · Mascoutah, IL
NPI number
1104007756
Active
Practice location
9640 Mallard Dr
Mascoutah, IL 62258-2762
Mailing address
215 N Broadway Ave
Salem, IL 62881-1511
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| General Practice Physician Primary | 208D00000X | None listed |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1104007756
Mind Body Spirit Care Clinic Inc's National Provider Identifier is 1104007756, issued on Nov 23, 2007. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Mascoutah, IL. The record was last updated on Nov 23, 2007.