| NPI | 1306915129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M MULVANEY President 618-244-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 060-008601) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |