Individual
MISS LORETTA PRICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5510 E STATE ST, ROCKFORD, IL 61108-2381
(815) 395-4505
Mailing address
5510 E STATE ST, ROCKFORD, IL 61108-2381
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005461
IL
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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