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Individual

ELISSA MARIE MCLANE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2600
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2600

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.004952
IL

Other

Enumeration date
06/26/2012
Last updated
06/26/2012
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