| NPI | 1386321404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BOLSTER Owner 630-362-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-06-30 |