Individual
KASSI DAWN MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
RURAL ROUTE BOX 270A, WAYNE CITY, IL 62895
(618) 231-3019
Mailing address
RURAL ROUTE BOX 270A, WAYNE CITY, IL 62895
(618) 231-3019
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005380
IL
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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