MRS. Amy Lynn Koudelka

NPI #1215101191 in Sparta, Illinois

Provider Information

NPI Number: 1215101191
Entity Type: Individual
Name: MRS. Amy Lynn Koudelka
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Apr 22, 2008
Last Updated: Jul 5, 2012

Practice Location

Address: 1300 N MARKET ST
City: Sparta
State: Illinois
ZIP Code: 62286-1048
Phone: (618) 443-2177

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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