Organization
LYMPHATIC WELLNESS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA WALLIN OT (MANAGING MEMBER/OWNER)
(708) 328-8594
Entity
Organization
Contact information
Practice address
120 S MADISON AVE, LA GRANGE, IL 60525-2340
(708) 328-8594
Mailing address
120 S MADISON AVE, LA GRANGE, IL 60525-2340
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
01/20/2021
Last updated
01/24/2022
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