Individual
VALERIE NICOLE DISSELKOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4108 N STATE ROUTE 1 17, MOMENCE, IL 60954-3481
(815) 214-4692
Mailing address
4108 N STATE ROUTE 1 17, MOMENCE, IL 60954-3481
(815) 214-4692
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.009852
IL
Other
Enumeration date
05/26/2023
Last updated
05/26/2023
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