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1104167659
GARY ALLAN PONCINIE
CHICAGO, IL
NPI
1104167659
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: IL 056008401)
Enumeration Date
2013-03-08
Last Update Date
2013-03-08
Business Address
-- GARY ALLAN PONCINIE OTR
1901 W HARRISON ST
CHICAGO, IL 60612-3714
Phone number: 312-864-3651
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Mailing Address
-- GARY ALLAN PONCINIE OTR
1901 W HARRISON ST
CHICAGO, IL 60612-3714
Phone number: 312-864-3651
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