Individual
MATT BRANCHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
370 N WEBER RD, BOLINGBROOK, IL 60440-1392
(331) 318-3098
Mailing address
505 N REED ST, JOLIET, IL 60435-5965
(815) 630-8357
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/12/2018
Last updated
08/12/2018
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