| NPI | 1184188443 |
|---|---|
| Doing Business As | AGE REHAB |
| Entity Type | Organization |
| Authorized Contact | VICTOR ERUDE LIDAYWA Owner / Physical Therapist 309-833-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2019-01-30 |
| Last Update Date | 2022-02-02 |