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Organization
PROFESSIONAL THERAPEUTIC GROUP, LLC
Active
Organization
PROFESSIONAL THERAPEUTIC GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LANA R JOYNER (ADMINISTRATOR/OWNER)
(618) 998-9894
Entity
Organization
Contact information
Practice address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
(618) 998-9993
Mailing address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
(618) 998-9993
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318540756001
—
IL
05
—
325688945001
—
IL
05
—
351786086001
—
IL
Enumeration date
07/12/2005
Last updated
08/01/2008
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