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1073850269
JACOBUS ANTON WELLERDIECK
GALESBURG, IL
NPI
1073850269
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070.008643)
Enumeration Date
2013-01-09
Last Update Date
2013-01-09
Business Address
-- JACOBUS ANTON WELLERDIECK PT
3333 N SEMINARY ST
GALESBURG, IL 61401-1251
Phone number: 309-344-9600
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Mailing Address
-- JACOBUS ANTON WELLERDIECK PT
3333 N SEMINARY ST
GALESBURG, IL 61401-1251
Phone number: 309-344-9600
Copy
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