Individual
MS. JOANN MARIE MATTALIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
9629 S MILLARD AVE, EVERGREEN PARK, IL 60805-2910
(708) 426-5645
(708) 425-0349
Mailing address
9629 S MILLARD AVE, EVERGREEN PARK, IL 60805-2910
(708) 426-5645
(708) 425-0349
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160001349
IL
Other
Enumeration date
05/30/2008
Last updated
05/30/2008
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