Individual
GRETCHEN R. SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
100 NE RANDOLPH AVE, PEORIA, IL 61606-1919
(309) 624-8578
(309) 624-8566
Mailing address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
(309) 655-7869
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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