Individual
LAURA SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1910 E MCCORD ST, CENTRALIA, IL 62801-6586
(618) 533-1200
Mailing address
18139 IRVINGTON RD, CENTRALIA, IL 62801-6690
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003714
IL
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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