| NPI | 1083769475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL DIANE BARBER Insurance Manager 217-245-1325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: IL 203000094) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2008-05-02 |