Individual
MRS. JAMIE J FIFAREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2404 E EMPIRE ST, BLOOMINGTON, IL 61704-3630
(309) 663-8275
(309) 662-7872
Mailing address
515 KREITZER AVE, BLOOMINGTON, IL 61701-5605
(309) 663-8275
(309) 662-7872
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
070017206
IL
Other
Enumeration date
07/27/2009
Last updated
07/27/2009
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