| NPI | 1326421074 |
|---|---|
| Other Name | ACTIVE LIFE PHYSICAL THERAPY AND WELLNESS |
| Entity Type | Organization |
| Authorized Contact | CONSTANTINE BOLOS President 847-323-7001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2015-06-30 |