Individual
MR. KEATON T KOROSEC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1838 VALLEYVIEW DR, FREEPORT, IL 61032-3614
(815) 291-8780
Mailing address
1838 VALLEYVIEW DR, FREEPORT, IL 61032-3614
(815) 291-8780
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007677
IL
Other
Enumeration date
02/13/2024
Last updated
02/13/2024
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