Individual
SANDY SHORTLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 S LAND ST, HARRISBURG, IL 62946-1849
(618) 252-7405
Mailing address
7579 GREEN MEADOW RD, THOMPSONVILLE, IL 62890-2416
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160002610
IL
Other
Enumeration date
04/09/2010
Last updated
04/09/2010
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