MR. Daniel Prudencio

NPI #1528363892 in Marion, Illinois

Provider Information

NPI Number: 1528363892
Entity Type: Individual
Name: MR. Daniel Prudencio
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Jan 18, 2011
Last Updated: Jan 18, 2011

Practice Location

Address: 2907 WILLIAMSON COUNTY PKWY
City: Marion
State: Illinois
ZIP Code: 62959-5256
Phone: (618) 998-9993

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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