Joy Marie Powell, MSPT, CERT. MDT

Individual provider Active NPI Physical Therapist · Elburn, IL

NPI 1679074454 · NPPES record last updated Feb 26, 2018

Key facts

NPI
1679074454
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
070.023357 (IL)
Practice address
1380 Spalding Ave
Elburn, IL 60119-7856
Phone
(616) 970-1227
NPI assigned
Feb 26, 2018
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)
Yes

State licenses

LicenseStateTypeSpecialty
070.023357ILMDPhysical Therapist
5501012467MIMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501012467 MI
Physical Therapist 225100000X 070.023357 IL Yes

Addresses

Primary practice location

1380 Spalding Ave
Elburn, IL 60119-7856

Mailing address

1380 Spalding Ave
Elburn, IL 60119-7856
Phone (616) 970-1227

Other providers in Elburn, IL

All providers in Elburn, IL · Physical Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.