Doctor Name: | MISS BRANDIE MARIE WILLSTEAD |
NPI Number: | 1164636239 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MPT |
License Number: | |
Business Practice Address: | 215 E 1st St Dixon, IL - 610213166 |
Business Phone Number: | 8152855591 |
Business Fax Number: | 1815285592 |
Mailing Address: | 610 E 3rd St, DIXON |
State: | IL |
Postal Code: | 610213210 |
Phone Number: | 8154401216 |
Fax Number: | |
NPI Enumeration Date: | 05/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |