SUSAN RENAE INGRAM

FLORA, IL
NPI1427693126
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IL  160-003878)
Enumeration Date2019-11-17
Last Update Date2019-11-21
Business Address
Mrs. SUSAN RENAE INGRAM LPTA
911 STACEY BURK DR
FLORA, IL 62839-3241
Phone number: 618-292-4655
Mailing Address
Mrs. SUSAN RENAE INGRAM LPTA
392 GOSHAWK LN
FARINA, IL 62838-3734
Phone number: 618-292-4655
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