| Organization Name: | CRAIG W. FURRY |
| NPI Number: | 1225223829 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CRAIG W FURRY (OWNER) |
| Mailing Address: | 20 N Washington St Suite 2 Du Quoin |
| State: | IL US |
| Postal Code: | 628321403 |
| Phone Number: | 6185422129 |
| Fax Number: | 6185422903 |
| NPI Enumeration Date: | 09/07/2007 |
| NPI Last Update Date: | 10/29/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 036067057 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |