| NPI | 1467473280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE JOHN WENZEL Physical Therapist 815-385-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070006566) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2007-10-11 |