Individual
KESTREL C DENNEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4401 N MAIN ST, ROCKFORD, IL 61103-1277
(815) 921-9200
Mailing address
1257 WILLARD AVE, ROCKFORD, IL 61101-2462
(815) 608-4590
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008477
IL
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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