Individual
MRS. MARION HUTCHINSON ILLICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
65 SCUDDER PL, NORTHPORT, NY 11768-3026
(631) 754-6791
Mailing address
65 SCUDDER PL, NORTHPORT, NY 11768-3026
(631) 754-6791
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
003909
NY
Other
Enumeration date
12/06/2008
Last updated
12/06/2008
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