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MRS. NANCY AINSWORTH GORDEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.A.

Contact information

Practice address
2300 N EDWARD ST, DECATUR, IL 62526-9986
(217) 876-2690
(217) 876-6825
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-9986
(217) 876-2690
(217) 876-6825

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160000669
IL

Other

Enumeration date
07/16/2012
Last updated
07/16/2012
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