Provider Demographics
NPI:1932242799
Name:MUNGER, MARCY LYNN (PT PHYSICAL THERAPIS)
Entity Type:Individual
Prefix:MS
First Name:MARCY
Middle Name:LYNN
Last Name:MUNGER
Suffix:
Gender:F
Credentials:PT PHYSICAL THERAPIS
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Mailing Address - Street 1:422 W MELROSE ST
Mailing Address - Street 2:APT 1410
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657
Mailing Address - Country:US
Mailing Address - Phone:989-400-3533
Mailing Address - Fax:
Practice Address - Street 1:19065 HICKORY CREEK DRIVE
Practice Address - Street 2:SUITE #110 KIDS CAN DO INC
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448
Practice Address - Country:US
Practice Address - Phone:708-478-5400
Practice Address - Fax:708-478-5300
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist