Individual
MARISSA LANGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1111 UNIVERSITY DR, EDWARDSVILLE, IL 62025-5589
(618) 692-2273
Mailing address
923 VIRGINIA DR, MARINE, IL 62061-1776
(618) 795-1081
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Enumeration date
07/02/2019
Last updated
07/02/2019
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