NPI | 1336400738 |
---|---|
Entity Type | Organization |
Authorized Contact | KARYN HAWBAKER Physical Therapist 309-657-7560 |
Organization Subpart ? | No |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL 070011663) |
Enumeration Date | 2012-06-01 |
Last Update Date | 2012-06-05 |