Individual
CARLA GAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
118 WESTHAVEN SCHOOL RD, BELLEVILLE, IL 62220-3264
(618) 257-9201
(618) 257-9201
Mailing address
105 W A ST, BELLEVILLE, IL 62220-1326
(618) 234-4294
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070-005647
IL
Other
Enumeration date
11/07/2017
Last updated
11/07/2017
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