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1992112486
BREEANNON CARLSON
ROCKFORD, IL
NPI
1992112486
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: IL 070020713)
Enumeration Date
2014-07-16
Last Update Date
2014-07-16
Business Address
Dr. BREEANNON CARLSON
5510 E STATE ST
ROCKFORD, IL 61108-2381
Phone number: 815-395-4505
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Mailing Address
Dr. BREEANNON CARLSON
5510 E STATE ST
ROCKFORD, IL 61108-2381
Phone number: 815-395-4505
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