| NPI | 1043813975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVIE A SHEW Physical Therapist 618-562-8142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2020-11-22 |
| Last Update Date | 2020-11-22 |