Individual
MALLORY LYNN REIBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PTA
Contact information
Practice address
1051 W SOUTH ST, KEWANEE, IL 61443-8354
(217) 871-9181
Mailing address
822 PULASKI ST, LINCOLN, IL 62656-2902
(217) 871-9181
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160009119
IL
2255A2300X
Athletic Trainer
096004692
IL
Other
Enumeration date
02/06/2017
Last updated
08/12/2025
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