Individual
KAITLYN STORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 BUTTERFIELD TRL, KANKAKEE, IL 60901-2959
(815) 936-6500
Mailing address
4560 SE INTERNATIONAL WAY, STU 100, MILWAUKIE, OR 97222-4628
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06004893A
IN
225200000X
Physical Therapy Assistant
Primary
16006902
IL
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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