Individual
MRS. PUNAM PANCHAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 BRITTANY DR, CHAMPAIGN, IL 61822-8522
(217) 898-7639
Mailing address
708 BRITTANY DR, CHAMPAIGN, IL 61822-8522
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160007448
IL
Other
Enumeration date
05/05/2017
Last updated
05/05/2017
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