Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070.003271 | IL |
NPI | 1003170184 |
---|---|
Provider Name | Lynn M Rinella |
First Address | Breese, IL 62230-3618 |
Second Address | Breese, IL 62230-3618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2012 |
Last Update Date | 03/07/2012 |