Individual
LAURA L TRAVELSTEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Mailing address
2907 WILLIAMSON COUNTY PKWY, MARION, IL 62959-5256
(618) 998-9894
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.000280
IL
Other
Enumeration date
11/22/2011
Last updated
11/22/2011
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