Individual
CALVIN JOHN EGGENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1200 E COLLEGE AVE, NORMAL, IL 61761-3100
(309) 533-7673
Mailing address
1822 GLENBRIDGE RD, BLOOMINGTON, IL 61704-8769
(619) 735-6105
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.013673
IL
Other
Enumeration date
08/03/2020
Last updated
08/04/2020
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