Individual
PATRICIA K VANTREASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
206 S PINE ST, ZEIGLER, IL 62999-1248
(618) 218-1832
Mailing address
206 S PINE ST, ZEIGLER, IL 62999-1248
(618) 218-1832
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
057001953
IL
Other
Enumeration date
04/11/2010
Last updated
04/11/2010
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