| NPI | 1053308015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN L BREFELD President 618-236-7588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 060004395) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 060004395) |
| 225X00000X Occupational Therapist (Licence: IL 060004395) | |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2007-11-21 |