Individual
MISS GAIL LYNN NEUKOMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1001 E PELLS ST, PAXTON, IL 60957-1300
(815) 867-1380
Mailing address
PO BOX 482, CISSNA PARK, IL 60924-0482
(815) 867-1380
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057003123
IL
Other
Enumeration date
11/13/2009
Last updated
11/13/2009
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