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General NPI Number Information
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NPI Number | 1235223058
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Entity Type | Organization
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Legal Business Name | COUNTY OF BOONE
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 04/17/2013
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Provider Practice Location Address
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Address Line | 1204 LOGAN AVENUE
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City | BELVIDERE
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State | IL
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Zip | 61008-4031
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Country | US
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Telephone | 815-547-8571
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Fax | 815-544-2050
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Provider Business Mailing Address
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Address Line | 1204 LOGAN AVENUE
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City | BELVIDERE
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State | IL
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Zip | 61008-4031
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Country | US
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Telephone | 815-547-8571
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Fax | 815-544-2050
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CYNTHIA FRANK
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Credential | B.S.
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Telephone | 815-547-8577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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