Individual
MICHAEL WARNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1790 S FAIRVIEW AVE, DECATUR, IL 62521-4010
(217) 429-2551
Mailing address
204 N MAIN ST, FARMER CITY, IL 61842-1212
(309) 928-2619
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057001557
IL
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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