Individual
MARYANN GILRUTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
605 S EDWARD DR, ROMEOVILLE, IL 60446-6507
(630) 863-7772
Mailing address
815 SUMMIT LN, BOLINGBROOK, IL 60440-1619
(630) 253-7291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160000277
IL
Other
Enumeration date
09/05/2012
Last updated
09/05/2012
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