Individual
ERIC VINCENT T MIRANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
901 GRANT ST, HARVARD, IL 60033-1821
(815) 943-5431
Mailing address
901 GRANT ST, HARVARD, IL 60033-1821
(815) 943-5431
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-008337
IL
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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