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Individual

DEBRA SUE TALLCOTT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1426 N 2250TH AVE, MENDON, IL 62351-2907
(217) 936-2534
Mailing address
1426 N 2250TH AVE, MENDON, IL 62351-2907
(217) 936-2534

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
01183
IA
225100000X
Physical Therapist
Primary
IL

Other

Enumeration date
09/12/2007
Last updated
09/12/2007
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