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Individual

MRS. GRETCHEN M RISER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L CHT

Contact information

Practice address
304 W HAY ST, SUITE 215, DECATUR, IL 62526-6328
(217) 875-4263
(217) 872-5481
Mailing address
304 W HAY ST, SUITE 215, DECATUR, IL 62526-6328
(217) 875-4263
(217) 872-5481

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
056005433
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05832033
BLUE CROSS BLUE SHIELD
IL
01
P00048436
RAILROAD MEDICARE
IL
Enumeration date
07/02/2006
Last updated
05/12/2010
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