Individual
HEATHER K BIRELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2381
Mailing address
2338 N GAINES ST, DAVENPORT, IA 52804-1909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.023988
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070.023988
PHYSICAL THERAPY LICENSE
IL
Enumeration date
09/22/2021
Last updated
09/22/2021
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