Individual
MIRABELA CRUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
55 FERRELL RD, ROSICLARE, IL 62982-1006
(618) 285-3655
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.009261
IL
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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