DYLAN JACOB SPENCER

WATERLOO, IL
NPI1912696246
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225400000X Rehabilitation Practitioner
Enumeration Date2023-05-03
Last Update Date2023-05-03
Business Address
DYLAN JACOB SPENCER RSA
988 N ILLINOIS ROUTE 3
WATERLOO, IL 62298-1059
Phone number: 618-939-4444
Mailing Address
DYLAN JACOB SPENCER RSA
PO BOX 146
WATERLOO, IL 62298-0146
Phone number: 618-939-4444