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Individual

MRS. CASEY DAWN MC DONNOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA, BS

Contact information

Practice address
101 N WALNUT ST, PINCKNEYVILLE, IL 62274-1034
(618) 357-5935
(618) 357-6336
Mailing address
53 COYOTE HOLLOW LN, VERGENNES, IL 62994-1438
(618) 559-0275

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004533
IL

Other

Enumeration date
06/20/2012
Last updated
06/20/2012
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