Individual
KAYLEIGH KERENSA MAGNUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
628 S ILLINOIS AVE, LITCHFIELD, IL 62056-2716
(217) 324-2153
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
(877) 787-3422
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008360
IL
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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