Individual
MRS. COURTNEY LYN MAYNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
306 W MILL ST, CARBONDALE, IL 62901-2727
(618) 529-3060
(618) 457-5372
Mailing address
1047 DAVIS CREEK LN, DU QUOIN, IL 62832-3738
(618) 542-3496
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056.005077
IL
Other
Enumeration date
11/06/2012
Last updated
11/06/2012
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