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Individual

MS. BREE ANN MCCLUSKY OCASIO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, PT

Contact information

Practice address
2110 FOX DR STE B, CHAMPAIGN, IL 61820-7596
(217) 366-1323
Mailing address
2110 FOX DR STE B, CHAMPAIGN, IL 61820-7596
(217) 366-1323

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
70015763
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113326
HEALTHLINK
IL
01
203
BLUE CROSS PROVIDER ID
IL
01
4117
HAMP PROVIDER ID
IL
01
7216
PERSONALCARE PROVIDER ID
IL
Enumeration date
08/23/2007
Last updated
07/13/2016
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