Individual
ABRAHAM ISAAC DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1203 EGYPTIAN TRL, TUSCOLA, IL 61953-2050
(217) 253-4791
Mailing address
608 N CENTER ST, TUSCOLA, IL 61953-1211
(217) 460-1394
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.003603
IL
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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