Individual
MRS. ASHLEY DEYONNE CORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
125 N. CEDAR ST, WATERMAN, IL 60556
(815) 264-8600
(815) 264-8644
Mailing address
49W230 HARTER RD, MAPLE PARK, IL 60151-8104
(815) 757-0431
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007518
IL
Other
Enumeration date
01/29/2018
Last updated
01/29/2018
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