Mia Anica Khey Fuentebella, PT

NPI #1710558465 in Danville, Illinois

Provider Information

NPI Number: 1710558465
Entity Type: Individual
Name: Mia Anica Khey Fuentebella, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Jul 5, 2021
Last Updated: Jul 5, 2021

Practice Location

Address: 812 N LOGAN AVE
City: Danville
State: Illinois
ZIP Code: 61832-3752
Phone: (217) 443-5000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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