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Individual

BROCK WAYNE ATHEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
1303 W EVERGREEN AVE, BIOMAX STE 102, EFFINGHAM, IL 62401
(217) 343-3400
(217) 342-9714
Mailing address
1303 W EVERGREEN AVE, BIOMAX STE 102, EFFINGHAM, IL 62401
(217) 343-3400
(217) 342-9714

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070018141
IL

Other

Enumeration date
11/03/2011
Last updated
11/03/2011
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