Individual
MICHAEL A STROUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
305 W JACKSON ST STE LL02, CARBONDALE, IL 62901-1474
(618) 549-0721
Mailing address
511 DOGWOOD LN, CARTERVILLE, IL 62918-1624
(618) 985-2237
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
96000511
IL
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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