Individual
KOZETTA LINETTE PUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
11860 SOUTHWEST HWY, PALOS HEIGHTS, IL 60463-1036
(708) 361-4555
Mailing address
11860 SOUTHWEST HWY, PALOS HEIGHTS, IL 60463-1036
(708) 361-4555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057-002956
IL
Other
Enumeration date
05/28/2010
Last updated
12/10/2015
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