NPI | 1073807319 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON KOTAS CFO 224-413-3927 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056.007545) |
Enumeration Date | 2011-06-03 |
Last Update Date | 2024-02-09 |