| NPI | 1003464728 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD MERTES CEO 815-513-3298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |