Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Dec 20, 2016
License(s)
070022228 (IL), 070-022228 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 600 OAKMONT LN STE 600C | Westmont, IL 60559-5548 | 630-575-1980 |
| LOCATION | 3714 N PROSPECT RD | Peoria, IL 61614-7743 | 309-550-7888 |
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