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1073920658
JENNIFER MARIE RIEDLE
MOUNT PULASKI, IL
NPI
1073920658
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057.002570)
Enumeration Date
2014-07-16
Last Update Date
2014-07-16
Business Address
MRS. JENNIFER MARIE RIEDLE COTA/L
412 1750TH AVE
MOUNT PULASKI, IL 62548-6641
Phone number: 217-871-5302
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Mailing Address
MRS. JENNIFER MARIE RIEDLE COTA/L
412 1750TH AVE
MT. PULASKI, IL 62548
Phone number: 217-871-5302
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