Individual
MRS. CARILYN FAY COKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
900 N WASHINGTON ST, DU QUOIN, IL 62832-1230
(618) 542-2146
Mailing address
411 W KING ST, COULTERVILLE, IL 62237-1529
(618) 758-1188
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
IL
Other
Enumeration date
05/22/2007
Last updated
07/08/2007
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