Individual
MARYKAY HOLMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
94 63RD ST, WILLOWBROOK, IL 60527-2982
(630) 850-7901
Mailing address
6200 OSAGE AVE, DOWNERS GROVE, IL 60516-2031
(630) 915-6257
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004887
IL
Other
Enumeration date
11/07/2011
Last updated
11/07/2011
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