Most Relevant Information
Provider Data
NPI Number: | 1003559600 |
Provider Name: | KATRINA KAY DURRE PTA |
Entity Type: | Individual |
Taxonomy Code: | 225200000X |
Specialty: | Physical Therapy Assistant |
License Number: |
Most Important Dates
Enumeration Date: | 04/20/2022 |
Last Updated: | 04/20/2022 |
Provider Practice Location
1402 LESLIE DR
BLOOMINGTON
IL
617045405
Practice Location Phone/Fax
Phone: | 3096032500 |
Fax: |
Provider Mailing Location
306 E LINCOLN ST
FLANAGAN
IL
617409030
Provider Mailing Phone/Fax
Phone: | 8154198153 |
Fax: |