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Individual

JOANNA FAUGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
24 CARROLLTON EST, MATTOON, IL 61938-9598
(217) 259-7353
Mailing address
11315 CORPORATE BLVD, SUITE 100, ORLANDO, FL 32817-8344

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160005726
IL

Other

Enumeration date
09/13/2011
Last updated
09/13/2011
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