Individual
BROOK RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 662-3311
Mailing address
2200 E WASHINGTON ST, BLOOMINGTON, IL 61701-4364
(309) 662-3311
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070017059
IL
Other
Enumeration date
08/23/2012
Last updated
08/23/2012
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