Individual
JOANIE MCDONOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 CENTENNIAL DR, EAST PEORIA, IL 61611-4912
(309) 694-9865
Mailing address
1101 N INSTITUTE PL, PEORIA, IL 61606-1020
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160000553
IL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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