Individual
MISS LINDSAY JOY BANNING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2600
Mailing address
2300 N EDWARD ST, DECATUR, IL 62526-4163
(217) 876-2600
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.005404
IL
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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