Most Relevant Information
Provider Data
NPI Number: | 1003540220 |
Provider Name: | GAYANA WANNIARACHCHI |
Entity Type: | Individual |
Taxonomy Code: | 213ES0103X |
Specialty: | Podiatrist |
License Number: | 135.001170 |
Most Important Dates
Enumeration Date: | 07/13/2022 |
Last Updated: | 07/13/2022 |
Provider Practice Location
215 E 1ST ST STE 111
DIXON
IL
610213198
Practice Location Phone/Fax
Phone: | 8153455677 |
Fax: |
Provider Mailing Location
215 E 1ST ST STE 111
DIXON
IL
610213198
Provider Mailing Phone/Fax
Phone: | |
Fax: |
Suggested EMR
Podiatry EMR