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1427307073
MATTHEW PHILIP DAVIDSON
ROCKFORD, IL
NPI
1427307073
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070.019382)
Enumeration Date
2012-08-29
Last Update Date
2012-08-29
Business Address
-- MATTHEW PHILIP DAVIDSON
5510 E STATE ST
ROCKFORD, IL 61108-2381
Phone number: 815-395-4505
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Mailing Address
-- MATTHEW PHILIP DAVIDSON
5510 E STATE ST
ROCKFORD, IL 61108-2381
Phone number:
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