Individual
KATHY LYNN HEARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
101 N. WALNUT ST., PINCKNEYVILLE, IL 62274
(618) 357-5935
Mailing address
474 KATHLEEN RD, DU QUOIN, IL 62832
(618) 790-4116
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160001840
IL
Other
Enumeration date
06/21/2012
Last updated
06/21/2012
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