Individual
MARY HOLOWATUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8521
(618) 288-5460
(618) 288-5567
Mailing address
6800 STATE ROUTE 162, MARYVILLE, IL 62062-8521
(618) 288-5460
(618) 288-5567
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056012541
IL
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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