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Individual

LACY MARIE REEDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1490 E WALNUT ST, WATSEKA, IL 60970-1806
(815) 432-0250
Mailing address
1490 E WALNUT ST, WATSEKA, IL 60970-1806
(815) 432-0250

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005441
IL

Other

Enumeration date
12/10/2012
Last updated
12/10/2012
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