| NPI | 1275072936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A MITOL Owner 773-368-8682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: TX 1235920) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |