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Individual

MS. KATELAN MEREDITH KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA, CBIS

Contact information

Practice address
950 S MULFORD RD, ROCKFORD, IL 61108-4274
(815) 381-8500
Mailing address
12825 PRAIRIE MEADOW WAY, BELVIDERE, IL 61008-8510
(515) 991-4900

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008275
IL

Other

Enumeration date
11/03/2021
Last updated
11/03/2021
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