Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 056012402 | IL |
NPI | 1225529613 |
---|---|
Provider Name | Sandee Muzyka |
First Address | La Grange, IL 60525-6130 |
Second Address | La Grange, IL 60525-6130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2018 |
Last Update Date | 05/10/2020 |