Organization
ALT THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TYLER KOONTZ LSW (CO-OWNER)
(618) 367-2138
Entity
Organization
Contact information
Practice address
1313 E HARDING DR, URBANA, IL 61801-6452
(815) 242-0701
Mailing address
1313 E HARDING DR, URBANA, IL 61801-6452
(815) 242-0701
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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