Individual
BRIAN UDELL FOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5668 STRATHMOOR DR, ROCKFORD, IL 61107-5110
(815) 229-5200
Mailing address
5259 TRAFFORD DR, LOVES PARK, IL 61111-3484
(815) 227-5797
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.003092
IL
Other
Enumeration date
10/10/2013
Last updated
10/11/2013
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