Individual
ANNE FAHNESTOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3311
Mailing address
611 W. PARK ST., FAPC, URBANA, IL 61801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070015433
IL
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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