Angela Marie Davault, OT

NPI #1003832379 in Bradley, Illinois

Provider Information

NPI Number: 1003832379
Entity Type: Individual
Name: Angela Marie Davault, OT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: OT
Enumeration Date: Jul 13, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 400 S KENNEDY DR
City: Bradley
State: Illinois
ZIP Code: 60915-2682
Phone: (815) 928-8051

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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