Individual
MR. JOSHUA INVENTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.T.
Contact information
Practice address
3303 GROVE AVE, UNIT 311, BERWYN, IL 60402-3432
(870) 324-0251
Mailing address
3303 GROVE AVE, UNIT 311, BERWYN, IL 60402-3432
(870) 324-0251
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008756
IL
Other
Enumeration date
02/11/2014
Last updated
02/11/2014
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