Individual
AMY RENEE NIEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 MEMORIAL DR, ALTON, IL 62002-6722
(618) 463-7429
Mailing address
1 MEMORIAL DR, ALTON, IL 62002-6722
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
056.009755
IL
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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