| NPI | 1093716318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO R. BALUGA Medical Director 815-397-4142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 042-007683) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-06-30 |