Individual
MR. DARVIS ELAM KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, MS ATC
Contact information
Practice address
107 TREMONT ST, HOPEDALE, IL 61747-7525
(309) 449-4501
Mailing address
107 TREMONT ST, HOPEDALE, IL 61747-7525
(309) 449-4501
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013320
IL
Other
Enumeration date
06/27/2012
Last updated
06/27/2012
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