UROLOGIC SURGERY ASSOCIATES, S.C.
Urology at Woodbine Rd, Bloomington, IL

License number
Illinois 042007836
Category
Radiology
Type
Urology
Owner
Name: MRS. ANNE THOMAS R.N.
Title: OFFICE MANAGER
Phone: (309) 661-9999
Address
Address
1414 Woodbine Rd, Bloomington, IL 61704
National Provider ID: 1831215391
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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UROLOGIC SURGERY ASSOCIATES, S.C

Mariano V Tolentino Jr 1414 Woodbine Rd, Bloomington, IL 61704

Registration:
Dec 18, 1996
State ID:
59172913
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
A Clay Cox,202 N Ctr St, Bloomington, IL 61701 (Physical)

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