Individual
ANNELIESE VICTORIA CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8605 WASHINGTON AVE, BROOKFIELD, IL 60513-1422
(708) 539-8448
Mailing address
8605 WASHINGTON AVE, BROOKFIELD, IL 60513-1422
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006057
IL
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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