Individual
MRS. CHRISTINE M GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3616 N MAIN ST, ROCKFORD, IL 61103-2159
(815) 877-5932
Mailing address
10808 N MAIN ST, ROCKTON, IL 61072-9456
(815) 624-2816
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070003815
IL
Other
Enumeration date
05/06/2007
Last updated
08/01/2008
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