EDWARD LEE PONCE

BLOOMINGTON, IL
NPI1528176138
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: IL  070-010014)
Additional Taxonomies2251X0800X Physical Therapist, Orthopedic
(Licence: IL  070010014)
Enumeration Date2006-08-25
Last Update Date2018-01-04
Business Address
Mr. EDWARD LEE PONCE PT
1111 TRINITY LN STE 111
BLOOMINGTON, IL 61704-8112
Phone number: 309-663-6461
Mailing Address
Mr. EDWARD LEE PONCE PT
1111 TRINITY LN STE 111
BLOOMINGTON, IL 61704-8112
Phone number: 309-663-6461