Lynn Bastuk PTA

NPI 1790103810 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1790103810
Gender Female
Enumeration Date 04/04/2014
Last Updated 04/04/2014
Entity Type Individual
Active Over 2 years ago
Practice Location
810 WASHINGTON ST
OREGON IL, 61061-1522, US
Phone (815) 732-4139
Fax
Business Location
810 WASHINGTON ST
OREGON IL, 61061-1522, US
Phone (815) 732-4139
Fax
Toxanomy
Taxonomy Code 225200000X
License State Illinois
License Number 160.005870
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According to our database, Lynn Bastuk PTA NPI is 1790103810, taxonomy code is 225200000X and license number is 160.005870, license state is located at Illinois. Lynn Bastuk PTA physically located at 810 Washington St, Oregon IL, 61061-1522. NPI Number Lynn Bastuk PTA has the Individual type.

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1790103810 NPI number is provided on an as is basis without warranty of any kind. 1790103810 is maintained by the National Plan & Provider Enumeration System. The contents of Lynn Bastuk PTA are for informational purposes only.