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Organization
PEDIATRIC PHYSICAL THERAPY OF CENTRAL ILLINOIS LTD
Active
Organization
PEDIATRIC PHYSICAL THERAPY OF CENTRAL ILLINOIS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN H GIBSON PT (PHYSICAL THERAPIST OWNER)
(217) 840-3915
Entity
Organization
Contact information
Practice address
123 W WILLIAM STREET, MONTICELLO, IL 61856
(217) 840-3915
Mailing address
PO BOX 211, 123 W WILLIAM STREET, MONTICELLO, IL 61856
(217) 840-3915
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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