NPI Provider: 1760472781
Contact Name: Newell L David
Position: President
Phone: (309) 266-5315
Bulldog Alliance Two Information:
Bulldog Alliance Two organization have npi 1760472781, taxonomy code is 333600000X with license number is in . This Business address located in 201 S Main St, Morton, IL 61550 Illinois.
Practice Location
Address: 201 S Main St, Morton, IL 61550
Phone: (309) 266-5315
Business Location
Address: 201 S Main St, Morton, IL 61550
Phone: (309) 266-5315
Taxonomy
Taxonomy Code: 333600000X
License Number:
License Number of State: IL
Primary Taxonomy Switch: Y
Enumeration Date: 10/21/2005
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