Individual
MS. ANDREA M PIASECKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
5111 22ND AVE, MOLINE, IL 61265-3681
(309) 762-7979
(309) 762-7979
Mailing address
5111 22ND AVE, MOLINE, IL 61265-3681
(309) 762-7979
(309) 762-8094
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070013907
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-013907
ILLINOIS PT LICENSE NUMBE
IL
Enumeration date
09/21/2006
Last updated
11/04/2008
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