Individual
BLANCA IRIS RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16101 WEBER RD, CRESTHILL, IL 60403-8812
(815) 306-1100
(815) 306-1105
Mailing address
16101 WEBER RD, CRESTHILL, IL 60403-8812
(815) 306-1100
(815) 306-1105
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004817
IL
Other
Enumeration date
08/24/2007
Last updated
11/15/2013
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