Individual
AMRUTA PRADHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 W WASHINGTON ST, SPRINGFIELD, IL 62711-7917
(217) 787-9600
Mailing address
2215A S KOKE MILL RD, SPRINGFIELD, IL 62711-9633
(309) 533-2130
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070019143
IL
Other
Enumeration date
06/30/2013
Last updated
06/30/2013
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