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1366413551
LISA D GUMMERMAN
PEORIA, IL
NPI
1366413551
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070016081)
Enumeration Date
2006-01-27
Last Update Date
2008-01-09
Business Address
-- LISA D GUMMERMAN PT
507 E ARMSTRONG AVE
PEORIA, IL 61603-3201
Phone number: 309-686-1177
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Mailing Address
-- LISA D GUMMERMAN PT
27 PENDLETON WAY
BLOOMINGTON, IL 61704-6243
Phone number: 217-622-3316
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