Individual
BRENDAN MOEHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1308 GAME FARM RD, YORKVILLE, IL 60560-2110
(630) 553-5811
Mailing address
1308 GAME FARM RD, YORKVILLE, IL 60560-2110
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070023677
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070023677
PHYSICAL THERAPIST LICENSE
IL
Enumeration date
08/27/2018
Last updated
08/27/2018
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