Individual
MS. VICKI GRABSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1323
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1323
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004632
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
032072002
TRICARE PROVIDER ID
IL
Enumeration date
09/20/2006
Last updated
09/25/2008
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