Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Aug 31, 2017
License(s)
070.023128 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3354 JEROME LN | Cahokia, IL 62206-2604 | 618-337-9400 |
| MAILING | 139 STONEBRIAR DR | Troy, IL 62294-1752 | 618-830-7195 |
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