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1700143898
SHANA B BERTELS
SHIPMAN, IL
NPI
1700143898
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: IL 057002709)
Enumeration Date
2012-04-13
Last Update Date
2012-04-13
Business Address
-- SHANA B BERTELS COTA
10354 PRAIRIE DELL RD
SHIPMAN, IL 62685-6105
Phone number: 618-836-7442
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Mailing Address
-- SHANA B BERTELS COTA
10354 PRAIRIE DELL RD
SHIPMAN, IL 62685-6105
Phone number: 618-836-7442
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