| NPI | 1386279214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT KIRK Authorized Official 708-710-9931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |