Individual
JULIE HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
550 S MULFORD RD, ROCKFORD, IL 61108-2511
(815) 399-4989
Mailing address
6421 WAYNE ST, UNION, IL 60180-9792
(815) 900-6987
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005910
IL
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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