Individual
CHRIS STUBBLEFIELD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
130 LICK CREEK RD, ANNA, IL 62906-3270
(618) 833-4300
Mailing address
402 S POPLAR ST, SESSER, IL 62884-1710
(618) 625-2311
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056005576
IL
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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