Individual
SHAN EVE WAID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6901 N GALENA RD, PEORIA, IL 61614-3193
(309) 692-4600
Mailing address
676 COUNTY ROAD 650 N, SPARLAND, IL 61565-9657
(309) 363-3061
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160009347
IL
Other
Enumeration date
01/01/2022
Last updated
01/01/2022
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