Individual
ERIN FASULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, MPT
Contact information
Practice address
7474 E STATE ST, ROCKFORD, IL 61108-2644
(158) 397-4439
(815) 397-4459
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070016144
IL
Other
Enumeration date
12/19/2007
Last updated
04/03/2018
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