Individual
PATRICK DAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
700 E WALNUT ST, BLOOMINGTON, IL 61701-3244
(309) 827-8004
(309) 827-0256
Mailing address
550 FRONTAGE RD, SUITE 2415, NORTHFIELD, IL 60093-1202
(847) 441-5593
(847) 441-0734
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160003356
IL
Other
Enumeration date
06/16/2010
Last updated
06/16/2010
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