Most Relevant Information
Provider Data
| NPI Number: | 1003436742 |
| Provider Name: | ANNE FAHNESTOCK PT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 070015433 |
Most Important Dates
| Enumeration Date: | 04/23/2020 |
| Last Updated: | 04/23/2020 |
Provider Practice Location
611 W PARK ST
URBANA
IL
618012529
Practice Location Phone/Fax
| Phone: | 2173833311 |
| Fax: |
Provider Mailing Location
611 W. PARK ST.
FAPC
URBANA
IL
61801
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |