Individual
KEALY A HOOTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPT
Contact information
Practice address
5100 E STATE ST, STE 200, ROCKFORD, IL 61108-2913
(815) 637-2200
(815) 637-2900
Mailing address
5100 E STATE ST, STE 200, ROCKFORD, IL 61108-2913
(815) 637-2200
(815) 637-2900
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
070014723
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070014723
LICENSED PHYSICAL THERAPIST
IL
Enumeration date
09/14/2009
Last updated
09/14/2009
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