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1154073559
CID ANTHONY MELOCOTON
SPRINGFIELD, IL
NPI
1154073559
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070008391)
Enumeration Date
2022-01-26
Last Update Date
2022-01-26
Business Address
Mr. CID ANTHONY MELOCOTON PT
2625 KIPLING DR
SPRINGFIELD, IL 62711-6232
Phone number: 217-899-1658
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Mailing Address
Mr. CID ANTHONY MELOCOTON PT
2625 KIPLING DR
SPRINGFIELD, IL 62711-6232
Phone number: 217-899-1658
Copy
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