Individual
PAIGE SUE KROGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2806 N KNOXVILLE AVE, PEORIA, IL 61604-2870
(309) 655-6961
Mailing address
2806 N KNOXVILLE AVE, PEORIA, IL 61604-2870
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
225X00000X
Occupational Therapist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/08/2019
Last updated
08/08/2022
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