Organization
ATHLETIC THERAPY CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL KETTLER (OFFICE MANAGER)
(618) 277-6282
Entity
Organization
Contact information
Practice address
2346 MASCOUTAH AVE, BELLEVILLE, IL 62220-3499
(618) 277-6282
Mailing address
2346 MASCOUTAH AVE, BELLEVILLE, IL 62220-3499
(618) 277-6282
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070004745
IL
Other
Enumeration date
11/07/2006
Last updated
06/18/2008
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