| NPI | 1104306315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN W BERGMANN President 708-227-2771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070020007) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |