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Individual

KATHRYN L. DHOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.A.

Contact information

Practice address
2110 FOX DR, CHAMPAIGN, IL 61820-7553
(217) 366-1323
(217) 366-8012
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1200
(217) 366-6106

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160-005465
IL

Other

Enumeration date
05/12/2011
Last updated
05/12/2011
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