| Radical Roots Clinic Llc | |
|
2046 Jonathan Creek Rd Arthur IL 61911-6108 | |
| (765) 267-1177 | |
| Not Available |
| Full Name | Radical Roots Clinic Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2046 Jonathan Creek Rd, Arthur, Illinois |
| Authorized Official Name and Position | Jessica Alford (OWNER) |
| Authorized Official Contact | 7652671177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Radical Roots Clinic Llc 2046 Jonathan Creek Rd Arthur IL 61911-6108 Ph: () - | Radical Roots Clinic Llc 2046 Jonathan Creek Rd Arthur IL 61911-6108 Ph: (765) 267-1177 |
| NPI Number | 1629737150 |
|---|---|
| Provider Enumeration Date | 12/13/2021 |
| Last Update Date | 05/30/2022 |
| Certification Date | 05/30/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629737150 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
Booker Counseling Services Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 520 W Palmer St, Arthur, IL 61911 Phone: 217-259-9680 | |
Southern Illinois Healthcare Foundation Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1710 State Route 133, Arthur, IL 61911 Phone: 217-543-2446 Fax: 217-543-2548 |