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1790933869
MARY JOLYNN PENTECOST
HERRIN, IL
NPI
1790933869
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160.002625)
Enumeration Date
2008-09-03
Last Update Date
2008-09-03
Business Address
Mrs. MARY JOLYNN PENTECOST PTA
1901 N. 13TH ST.
HERRIN, IL 62948
Phone number: 618-942-3274
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Mailing Address
Mrs. MARY JOLYNN PENTECOST PTA
1901 N. 13TH ST.
HERRIN, IL 62948
Phone number: 618-942-3274
Copy
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