Individual
ANNE LYLE ILLGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
705 17TH ST STE 407, COLUMBUS, GA 31901-3514
(706) 321-0930
Mailing address
8272 DREAM BOAT DR UNIT 224, COLUMBUS, GA 31909-2556
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006838
GA
Other
Enumeration date
09/21/2017
Last updated
09/21/2017
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