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Individual

KOLINA ARLENE BAUCOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.T.

Contact information

Practice address
620 WABASH AVE, CARTHAGE, IL 62321-1444
(217) 357-9000
(217) 357-9013
Mailing address
3032 BROADWAY ST, QUINCY, IL 62301-3708
(217) 222-6800
(217) 222-0037

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009839
IL

Other

Enumeration date
09/04/2012
Last updated
10/26/2016
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