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Individual

MRS. SHARON CHARLENE UTTERBACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPTA

Contact information

Practice address
2 ANNABLE CT, CAHOKIA, IL 62206-2204
(618) 332-7710
(618) 332-7710
Mailing address
224 LAS OLAS DR, BELLEVILLE, IL 62221-3117
(618) 558-0830
(618) 332-7710

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004185
IL
225200000X
Physical Therapy Assistant
2004018741
MO

Other

Enumeration date
06/01/2012
Last updated
06/01/2012
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