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1134134992
IVY GALLARDO DONNELLY
MARION, IL
NPI
1134134992
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070-007357)
Enumeration Date
2006-07-30
Last Update Date
2007-07-08
Business Address
-- IVY GALLARDO DONNELLY PT
2401 W MAIN ST
MARION, IL 62959-1188
Phone number: 618-997-5311
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Mailing Address
-- IVY GALLARDO DONNELLY PT
600 E MERIDIAN ST
MARION, IL 62959-3554
Phone number: 618-997-5311
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