Individual
MARCIE R BURTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
300 E MAZON AVE, DWIGHT, IL 60420-1104
(815) 584-1240
Mailing address
1708 N AURORA ST, PONTIAC, IL 61764-1201
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
Primary
057002456
IL
Other
Enumeration date
05/25/2022
Last updated
05/25/2022
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