Individual
AMY LARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1002 POPES CREEK CIR, GRAYSLAKE, IL 60030-1143
(724) 372-5215
(888) 990-2910
Mailing address
1002 POPES CREEK CIR, GRAYSLAKE, IL 60030-1143
(724) 372-5215
(888) 990-2910
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
004293
IA
225100000X
Physical Therapist
Primary
070012702
IL
225100000X
Physical Therapist
12905
WI
Other
Enumeration date
07/08/2014
Last updated
01/20/2015
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