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General NPI Number Information
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NPI Number | 1174062996
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Entity Type | Organization
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Legal Business Name | DENISE PURVIS BILLING SERVICES
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Dates
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Enumeration Date | 02/13/2017
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Last Update Date | 02/13/2017
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Provider Practice Location Address
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Address Line | 5301 E STATE ST STE 301
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City | ROCKFORD
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State | IL
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Zip | 61108-2399
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Country | US
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Telephone | 815-226-8146
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Fax |
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Provider Business Mailing Address
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Address Line | 106 JATA DR
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City | MONROE CENTER
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State | IL
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Zip | 61052-9794
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Country | US
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Telephone | 815-226-8146
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DENISE PURVIS
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Credential |
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Telephone | 815-226-8146
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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