Individual
ABBY G HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1440 W WALNUT ST, #2, JACKSONVILLE, IL 62650-1143
(217) 245-1455
(217) 243-6903
Mailing address
1440 W WALNUT ST, #2, JACKSONVILLE, IL 62650-1143
(217) 245-1455
(217) 243-6903
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013500
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005415281
BCBS
IL
01
—
216653
GROUP PTAN
IL
01
—
K51651
PTAN
IL
Enumeration date
01/11/2006
Last updated
07/15/2008
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