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Individual

DARCEE LYNN DIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
810 W ANTHONY DR, URBANA, IL 61802-7431
(217) 383-3400
Mailing address
504 N MAIN ST, PO BOX 243, FITHIAN, IL 61844-9700

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
05009175A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200845000
EARLY INTERVENTION
IN
05
200848330
IN
Enumeration date
03/12/2007
Last updated
05/30/2008
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