Individual
MRS. PATRICIA S LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
650 N MAIN ST, ROCKFORD, IL 61103-6921
(815) 965-6745
(815) 968-9563
Mailing address
4871 RADNOR DR, ROCKFORD, IL 61109-3126
(815) 874-9142
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
IL
Other
Enumeration date
06/12/2007
Last updated
07/08/2007
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