JAN CLARENCE GUTIERREZ DIMLA

DANVILLE, IL
NPI1215455027
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: IL  070022794)
Enumeration Date2017-08-31
Last Update Date2017-08-31
Business Address
Mr. JAN CLARENCE GUTIERREZ DIMLA PT
14792 CATLIN TILTON RD
DANVILLE, IL 61834-5116
Phone number: 217-443-6430
Mailing Address
Mr. JAN CLARENCE GUTIERREZ DIMLA PT
702 LURIA LN
CHAMPAIGN, IL 61822-1107
Phone number: 217-550-9634
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