| NPI | 1053557264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRAB MICKEY SHAH Physical Therapist 708-966-4386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-013727) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2008-12-18 |
| Last Update Date | 2024-08-01 |