Individual
MR. DOUGLAS SKIP FABRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
202 W AGARD ST, WYOMING, IL 61491-1324
(309) 883-5733
Mailing address
202 W AGARD ST, WYOMING, IL 61491-1324
(309) 883-5733
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.003513
IL
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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