NPI 1003428806

Staci a Burris, PTA

Practitioner Physical Therapy Assistant East Peoria, IL

Practice location

Address: 900 Centennial Dr # 30, East Peoria, IL 61611-4928
Phone: (309) 699-5400
Mailing address: 1141 N Nancy St, East Peoria, IL 61611-9554

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 160005049 (IL)

Other Physical Therapy Assistant providers in Illinois →

Registry record

NPI: 1003428806
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Aug 2020
Record last updated: 21 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.