Individual
REBECCA ILLIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2310 LEETONIA RD, LEETONIA, OH 44431-9785
(330) 692-5947
Mailing address
2310 LEETONIA RD, LEETONIA, OH 44431-9785
(330) 692-5947
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/30/2016
Last updated
06/30/2016
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