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1962852582
MAGGI CROCKETT
ALSIP, IL
NPI
1962852582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IL 160.007483)
Enumeration Date
2016-06-14
Last Update Date
2016-06-14
Business Address
-- MAGGI CROCKETT PTA
12052 S CICERO AVE
ALSIP, IL 60803-2313
Phone number: 708-489-9940
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Mailing Address
-- MAGGI CROCKETT PTA
790 REMINGTON BLVD
BOLINGBROOK, IL 60440-4909
Phone number: 630-296-2223
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