| Rejuv Peoria Pc | |
|
501 N Morton Ave Morton IL 61550-1526 | |
| (309) 263-4673 | |
| (309) 263-4611 |
| Full Name | Rejuv Peoria Pc |
|---|---|
| Speciality | Clinic/center |
| Location | 501 N Morton Ave, Morton, Illinois |
| Authorized Official Name and Position | Shawn Christopher Snider (OWNER) |
| Authorized Official Contact | 3096784243 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Rejuv Peoria Pc 501 N Morton Ave Morton IL 61550-1526 Ph: (309) 263-4673 | Rejuv Peoria Pc 501 N Morton Ave Morton IL 61550-1526 Ph: (309) 263-4673 |
| NPI Number | 1801156377 |
|---|---|
| Provider Enumeration Date | 05/18/2012 |
| Last Update Date | 05/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801156377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | IL036086752 (Illinois) | Primary |
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