ELIAS BOUSHEH
Individual Provider (NPI-1)
Active
Physical Therapist
Provider Information
- NPI Number
1902376239- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 5255 E MARYLAND ST, DECATUR, IL, 625219705
- Phone
- (217) 864-1264
- Fax
- (217) 864-1828
Specialties & Taxonomies
Specialist/Technologist, Athletic Trainer
Physical Therapist
Primary License: IL #070027717