SearchIllinois171R00000X

Crystal Grove

NPI 1013225184 · on the registry since 2010 · sole proprietor

Practice

Address
1149 Hazel Dell Rd
Greenville, IL 62246
Phone
(618) 335-1624

Registry record

Primary taxonomy
171R00000X
171R00000X
Sex
Female
Record last updated
2010-09-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois