Individual
JILL ELLEN BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
400 W WASHINGTON AVE, CHRISMAN, IL 61924-1042
(217) 269-2105
Mailing address
104 S HOPKINS ST, NEWMAN, IL 61942-9401
(217) 837-2889
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002460
IL
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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