Individual
DANIEL CLEARWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
221 S MAPLE AVE APT B, OAK PARK, IL 60302-3095
(708) 250-7046
Mailing address
221 S MAPLE AVE APT B, OAK PARK, IL 60302-3095
(708) 250-7046
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004741
IL
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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