Most Relevant Information
Provider Data
| NPI Number: | 1003501974 |
| Provider Name: | ERIC TYLER AMPARAN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/06/2023 |
| Last Updated: | 04/06/2023 |
Provider Practice Location
530 NE GLEN OAK AVE
PEORIA
IL
616370001
Practice Location Phone/Fax
| Phone: | 3096552274 |
| Fax: |
Provider Mailing Location
530 NE GLEN OAK AVE
PEORIA
IL
616370001
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |