NPI 1962257642

Natalie J Gallivan

Practitioner Mastectomy Fitter Bloomington, IL

Practice location

Address: 3002 Gill St, Bloomington, IL 61704-3438
Phone: (309) 664-7930
Fax: (309) 664-7931
Mailing address: 28099 W Rockwell CT, Lakemoor, IL 60051-6606

Registered specialties

Mastectomy Fitter Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224900000X

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Registry record

NPI: 1962257642
Entity type: Individual
Sex (as registered): Female
NPI issued: 17 Apr 2024
Record last updated: 17 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.