| NPI | 1114300654 |
|---|---|
| Former Legal Business Name | REHAB AND SPORTS MED OUTFITTERS OF FOX VALLEY |
| Entity Type | Organization |
| Authorized Contact | MARK P NASO CEO 630-383-9404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 056005093) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |