Individual
MRS. ANGELICA ELIZABETH GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1219 W ROOSEVELT RD, MAYWOOD, IL 60153-4046
(888) 584-7888
(708) 531-7936
Mailing address
3243 OAK AVE, BROOKFIELD, IL 60513-1317
(708) 769-9530
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005103
IL
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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