Individual
KATIE BOUDREAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1601 BUTTERFIELD TRL, KANKAKEE, IL 60901-2959
(815) 936-6500
Mailing address
6170 W 2000N RD, BONFIELD, IL 60913-6700
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.006489
IL
Other
Enumeration date
01/03/2014
Last updated
01/03/2014
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