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Individual

MRS. KATIE JO CLODFELTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
801 N LOGAN AVE, DANVILLE, IL 61832-3715
(217) 443-3106
(217) 443-3187
Mailing address
3801 OLD BRUCEVILLE RD, VINCENNES, IN 47591-3889
(812) 886-4677
(812) 886-4678

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06004433A
IN
225200000X
Physical Therapy Assistant
Primary
160004650
IL

Other

Enumeration date
07/10/2012
Last updated
07/10/2012
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