Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jan 9, 2013
License(s)
070019631 (IL), 0009468 (CO)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2649 E 75TH ST | Chicago, IL 60649-3835 | 773-356-9300 |
| LOCATION | 2649 E 75TH ST | Chicago, IL 60649-3835 | 773-356-9300 |
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