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Jacob Radden, PT, DPT, PES Valid NPI

Individual provider · Physical Therapist · O Fallon, IL

NPI
1588389829
Type
Individual (Type 1)
Primary specialty
Physical Therapist
Specialty group
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy code
225100000X
License number
070.027003 (IL)
Sex
Male
Sole proprietor
No
Enumerated
2022-10-10
Last updated
2022-10-10
Practice location
821 W Highway 50 Ste 150
O Fallon, IL 62269-1828
(618) 726-0370

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