Organization
ASSISTEDCARE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE D POWELL O.T. (OCCUPATIONAL THERAPIST)
(618) 841-3232
Entity
Organization
Contact information
Practice address
2410 HILLCREST ST, HARRISBURG, IL 62946-3869
(618) 841-3232
Mailing address
2410 HILLCREST ST, HARRISBURG, IL 62946-3869
(618) 841-3232
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056006921
IL
Other
Enumeration date
04/06/2010
Last updated
04/06/2010
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