Individual
AMY WEDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
209 9TH ST, ROCKFORD, IL 61104-2235
(779) 696-4470
Mailing address
209 9TH ST STE 302, ROCKFORD, IL 61104-2235
(779) 696-4470
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056011023
IL
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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