| NPI | 1336468966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN JOE KATHALYNAS Owner 618-932-2137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2022-04-12 |