NPI | 1306880414 |
---|---|
Entity Type | Organization |
Authorized Contact | LESLIE ELMER Mangaer, Credentialing And Risk 815-381-7431 |
Organization Subpart ? | Yes |
Primary Taxonomy | 335E00000X Prosthetic/Orthotic Supplier |
Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology |
207X00000X Orthopaedic Surgery | |
207XS0106X Orthopaedic Surgery, Hand Surgery | |
207XX0005X Orthopaedic Surgery, Sports Medicine | |
207XX0801X Orthopaedic Surgery, Orthopaedic Trauma | |
363A00000X Physician Assistant | |
208100000X Physical Medicine & Rehabilitation | |
225100000X Physical Therapist | |
2251X0800X Physical Therapist, Orthopedic | |
225X00000X Occupational Therapist | |
332B00000X Durable Medical Equipment & Medical Supplies | |
Enumeration Date | 2006-06-16 |
Last Update Date | 2019-09-11 |