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Individual

MR. DANE B MORITA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
550 S CEDAR AVE, ELMHURST, IL 60126-4136
(630) 290-1148
Mailing address
550 S CEDAR AVE, ELMHURST, IL 60126-4136
(630) 290-1148

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070005137
IL
225100000X
Physical Therapist
O7O.005137
IL

Other

Enumeration date
10/17/2020
Last updated
10/17/2020
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