Individual
COURTNEY FENOGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1901 N 13TH ST, HERRIN, IL 62948-2839
(618) 942-7391
Mailing address
1901 N 13TH ST, HERRIN, IL 62948-2839
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.004590
IL
Other
Enumeration date
12/08/2021
Last updated
12/08/2021
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