ACTIVE LIFE SPINE & JOINT CLINIC LLC

ROCKFORD, IL
NPI1083187553
Entity TypeOrganization
Authorized ContactRONALD SAMANIEGO
Owner
224-425-0548
Organization Subpart ?No
Primary Taxonomy225100000X Physical Therapist
Enumeration Date2019-01-08
Last Update Date2019-01-08
Business Address
ACTIVE LIFE SPINE & JOINT CLINIC LLC
3600 E STATE ST STE 222
ROCKFORD, IL 61108-1956
Phone number: 224-425-0548
Mailing Address
ACTIVE LIFE SPINE & JOINT CLINIC LLC
3600 E STATE ST STE 222
ROCKFORD, IL 61108-1956
Phone number: