Mary Carol Mahieu PTA

NPI 1619141660 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1619141660
Gender Female
Enumeration Date 04/21/2008
Last Updated 04/21/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
6501 N SHERIDAN RD
PEORIA IL, 61614-2932, US
Phone (309) 692-8110
Fax
Business Location
6501 N SHERIDAN RD
PEORIA IL, 61614-2932, US
Phone
Fax
Toxanomy
Taxonomy Code 225200000X
License State Illinois
License Number 160000202
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According to our database, Mrs. Mary Carol Mahieu PTA NPI is 1619141660, taxonomy code is 225200000X and license number is 160000202, license state is located at Illinois. Mary Carol Mahieu PTA physically located at 6501 N Sheridan Rd, Peoria IL, 61614-2932. NPI Number Mary Carol Mahieu PTA has the Individual type.

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1619141660 NPI number is provided on an as is basis without warranty of any kind. 1619141660 is maintained by the National Plan & Provider Enumeration System. The contents of Mary Carol Mahieu PTA are for informational purposes only.