Individual
MRUNAL GAUTAM CHOKSHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(716) 866-4954
Mailing address
1908 CENTURY DR, EUREKA, IL 61530-1667
(716) 866-4954
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
5501014647
MI
2251X0800X
Orthopedic Physical Therapist
Primary
070022764
IL
2251X0800X
Orthopedic Physical Therapist
5501014647
MI
Other
Enumeration date
02/26/2013
Last updated
01/21/2017
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