Individual
SALLY MARTHA MCKANNA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5533 N GALENA RD, PEORIA HEIGHTS, IL 61616-4447
(309) 682-5428
Mailing address
1590 COUNTY ROAD 425 E, METAMORA, IL 61548-7835
(815) 263-2517
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004478
IL
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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