Individual
ERIN STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
216 COLLEGE BLVD, CARMI, IL 62821-1548
(618) 382-4644
Mailing address
170 QUAILS RUN LN, HARRISBURG, IL 62946-5292
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160004134
IL
Other
Enumeration date
09/19/2008
Last updated
08/01/2013
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