| NPI | 1124354931 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD SAMANIEGO Owner 847-322-6551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 1015624) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WI 488612) |
| 225100000X Physical Therapist (Licence: IL 070014146) | |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2013-03-26 |