| Specialty Clinic | |
|
818 E Broadway St Sparta IL 62286 | |
| (618) 443-2177 | |
| (618) 443-1358 |
| Full Name | Specialty Clinic |
|---|---|
| Speciality | Clinic/center |
| Location | 818 E Broadway St, Sparta, Illinois |
| Authorized Official Name and Position | Michael Hayes (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 6184432177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Specialty Clinic 818 E Broadway St Sparta IL 62286-1820 | Specialty Clinic 818 E Broadway St Sparta IL 62286 Ph: (618) 443-2177 |
| NPI Number | 1154626448 |
|---|---|
| Provider Enumeration Date | 01/18/2011 |
| Last Update Date | 08/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154626448 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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