Individual
JUNIOR LYNN ELLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L, MHA
Contact information
Practice address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9784
(815) 842-4584
(815) 842-6893
Mailing address
2500 W REYNOLDS ST, PONTIAC, IL 61764-9784
(815) 842-4584
(815) 842-6893
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056-002654
IL
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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