Individual
BRIAN STANISZEWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
Mailing address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(309) 676-5546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.013318
IL
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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