Individual
MRS. SHAWN L WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
107 TREMONT ST, HOPEDALE, IL 61747-7525
(309) 449-4501
(309) 449-4525
Mailing address
107 TREMONT ST, HOPEDALE, IL 61747-7525
(309) 449-4501
(309) 449-4525
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002010
IL
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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