Doctor Name: | DR. LAUREN PETRICE EISELE |
NPI Number: | 1518364025 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DVM |
License Number: | 090.010318 |
Business Practice Address: | 9351 Old Highway 13 Murphysboro, IL - 629665530 |
Business Phone Number: | 6186871766 |
Business Fax Number: | |
Mailing Address: | 9351 Old Highway 13, MURPHYSBORO |
State: | IL |
Postal Code: | 629665530 |
Phone Number: | 6186871766 |
Fax Number: | |
NPI Enumeration Date: | 11/26/2014 |
NPI Last Update Date: | 11/26/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174M00000X |
License Number: | 090.010318 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Veterinarian |
Taxonomy Specialization: | |
Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |