Ivy Gallardo Donnelly PT

NPI 1134134992 - Physical Therapist - 225100000X

NPI Details
NPI 1134134992
Gender Female
Enumeration Date 07/30/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
2401 W MAIN ST
MARION IL, 62959-1188, US
Phone (618) 997-5311
Fax (618) 998-5688
Business Location
600 E MERIDIAN ST
MARION IL, 62959-3554, US
Phone (618) 997-5311
Fax (618) 998-5688
Toxanomy
Taxonomy Code 225100000X
License State Illinois
License Number 070-007357
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According to our database, Ivy Gallardo Donnelly PT NPI is 1134134992, taxonomy code is 225100000X and license number is 070-007357, license state is located at Illinois. Ivy Gallardo Donnelly PT physically located at 2401 W Main St, Marion IL, 62959-1188. NPI Number Ivy Gallardo Donnelly PT has the Individual type.

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1134134992 NPI number is provided on an as is basis without warranty of any kind. 1134134992 is maintained by the National Plan & Provider Enumeration System. The contents of Ivy Gallardo Donnelly PT are for informational purposes only.