| NPI | 1346828563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB DANIEL LEDESMA Owner/Physical Therapist 815-295-4320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2021-03-30 |