Individual
MARY CHILDRESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 E WADSWORTH PARK DR STE 230, DRAPER, UT 84020-8096
(385) 308-8034
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
000025951
MA
225100000X
Physical Therapist
019570
OH
225100000X
Physical Therapist
030109
PA
225100000X
Physical Therapist
040-0134309
VT
225100000X
Physical Therapist
048155
NY
225100000X
Physical Therapist
05014416A
IN
225100000X
Physical Therapist
37906
FL
225100000X
Physical Therapist
Primary
7971
SC
225100000X
Physical Therapist
PTH10588
AL
225100000X
Physical Therapist
—
—
Other
Enumeration date
10/16/2015
Last updated
06/20/2024
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