Doctor Name: | MRS. KELLY S MC CORMICK |
NPI Number: | 1235378449 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.T. |
License Number: | 070016904 |
Business Practice Address: | 1719 Clawson St Alton, IL - 620024702 |
Business Phone Number: | 6184621133 |
Business Fax Number: | 6184623736 |
Mailing Address: | 1719 Clawson St, ALTON |
State: | IL |
Postal Code: | 620024702 |
Phone Number: | 6184621133 |
Fax Number: | 6184623736 |
NPI Enumeration Date: | 02/11/2009 |
NPI Last Update Date: | 11/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070016904 |
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 |