Individual
SANDRA JEAN SOWADA RIVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1507 7TH ST, LINCOLN, IL 62656-2216
(217) 732-4826
(217) 732-8041
Mailing address
3208 BOWWOOD DR, SPRINGFIELD, IL 62712-8944
(217) 585-1678
(217) 732-8041
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
056.008030
IL
Other
Enumeration date
07/07/2008
Last updated
07/07/2008
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