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Revelle Goldsmith
Rehabilitation Practitioner in Waterloo, Illinois
NPI 1164071353

Revelle Goldsmith is a Rehabilitation Practitioner based in Waterloo, IL. Revelle Goldsmith practices in Waterloo, IL. The NPI Number for Revelle Goldsmith is 1164071353 and holds a License No. (Illinois).

The current practice location address for Revelle Goldsmith is 988 N Illinois Route 3, Waterloo, IL and can be reached out via phone at 618-939-4444. You can also correspond with Revelle Goldsmith through the mailing address at 988 N ILLINOIS ROUTE 3, WATERLOO, IL - 62298-1059 (mailing address contact number: 618-939-4444).

Location: 988 N Illinois Route 3, Waterloo, IL, 62298-1059
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1164071353
Provider Name
Revelle Goldsmith
Credential
Provider Entity Type
Individual
Gender
Male
Address
988 N Illinois Route 3, Waterloo, IL, 62298-1059
Phone Number
618-939-4444
Fax Number
Provider Enumeration Date
09/10/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
988 N Illinois Route 3
City
Waterloo
State
Illinois
Zip
62298-1059
Phone Number
618-939-4444
Fax Number
person
Provider Business Mailing Address Details
Address
988 N Illinois Route 3
City
Waterloo
State
Illinois
Zip
62298-1059
Phone Number
618-939-4444
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Rehabilitation Practitioner
Speciality
-
Taxonomy
225400000X
License No.
()
Definition
A health care practitioner who trains or retrains individuals disabled by disease or injury to help them attain their maximum functional capacity.
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