Tricia Casford

Individual provider Active NPI Physical Therapy Assistant · Peru, IL

NPI 1114607496 · NPPES record last updated Jul 20, 2023

Key facts

NPI
1114607496
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
160.003649 (IL)
Practice address
1424 Midtown Rd
Peru, IL 61354-1271
Phone
(815) 538-1354
NPI assigned
Jul 20, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
160.003649ILMDPhysical Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 160.003649 IL Yes

Addresses

Primary practice location

1424 Midtown Rd
Peru, IL 61354-1271

Mailing address

1424 Midtown Rd
Peru, IL 61354-1271

Other providers in Peru, IL

All providers in Peru, IL · Physical Therapy Assistant in Illinois

Sources for this page

Verify at the official NPI Registry.