Individual
KELLY M GOUSSET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1509 FARNSWORTH, AURORA, IL 60505
(630) 585-5901
Mailing address
PO BOX 2103, NAPERVILLE, IL 60567-2103
(630) 428-5850
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002729
IL
Other
Enumeration date
05/28/2008
Last updated
05/28/2008
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