| NPI | 1437625001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KATHLEEN BUCCELLI Physical Therapist 224-628-4411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2018-10-22 |