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Individual

AMANDA JEAN CANTWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
504 5TH ST, CRETE, IL 60417-2110
(708) 460-9833
(708) 460-1117
Mailing address
PO BOX 379, ORLAND PARK, IL 60462-0379
(708) 460-9833
(708) 460-1117

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009427
IL

Other

Enumeration date
12/07/2017
Last updated
12/07/2017
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