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Individual

ELAINE IMONIRUWE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
25117 SW PARKWAY AVE, STE.D, WILSONVILLE, OR 97070-9697
(971) 224-2040
Mailing address
8646 S INGLESIDE AVE APT 2C, CHICAGO, IL 60619-6373
(989) 996-0060

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006945
IL

Other

Enumeration date
10/29/2014
Last updated
10/29/2014
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