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Individual

BRENDA GAIL CRUTCHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
12490 N WELDON RD, ROCKFORD, IL 61102-9640
(815) 289-6325
Mailing address
12490 N WELDON RD, ROCKFORD, IL 61102-9640
(815) 289-6325

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160003860
IL

Other

Enumeration date
06/17/2008
Last updated
06/17/2008
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