Individual
MS. CHRISTINE DEVERELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
403 S GEAR AVE, SUITE 105, WEST BURLINGTON, IA 52655-1068
(319) 752-5129
(319) 752-5164
Mailing address
PO BOX 5387, BLOOMINGTON, IL 61702-5387
(309) 661-8823
(309) 661-8801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
004234
IA
225100000X
Physical Therapist
070014622
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37-1365409
WELLMARK
IA
Enumeration date
12/28/2006
Last updated
04/20/2011
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