Individual
SELENA WAIDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1401 E 12TH ST, MENDOTA, IL 61342-9216
(815) 539-1409
(815) 539-1652
Mailing address
1401 E 12TH ST, MENDOTA, IL 61342-9216
(815) 539-1409
(815) 539-1652
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008276
IL
Other
Enumeration date
04/22/2022
Last updated
04/22/2022
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