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1033412002
STEPHEN S POTISUK
ST CHARLES, IL
NPI
1033412002
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070.011469)
Enumeration Date
2010-12-14
Last Update Date
2010-12-14
Business Address
Mr. STEPHEN S POTISUK PT
44W121 EMPIRE RD
ST CHARLES, IL 60175-8256
Phone number: 630-337-9545
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Mailing Address
Mr. STEPHEN S POTISUK PT
44W121 EMPIRE RD
ST CHARLES, IL 60175-8256
Phone number: 630-337-9545
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