Individual
FERN REARDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
1200 E PARTRIDGE ST, METAMORA, IL 61548-9619
(309) 367-4300
Mailing address
247 E DELWOOD ST, MORTON, IL 61550-2512
(309) 267-8541
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003454
IL
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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