Individual
MOLLY STEPHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
634 N MAIN ST STE 3, O FALLON, IL 62269-3746
(618) 632-4222
Mailing address
634 N MAIN ST STE 3, O FALLON, IL 62269-3746
(618) 632-4222
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160009239
IL
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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