Individual
ALYSSA EMBICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
815 E 5TH ST, ALTON, IL 62002-6471
(618) 463-5171
Mailing address
815 E 5TH ST, ALTON, IL 62002-6471
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011148
IL
225X00000X
Occupational Therapist
2015017109
MO
Other
Enumeration date
02/06/2017
Last updated
02/06/2017
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