| NPI | 1518404243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISSA SOMERS Ownder 309-826-7430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WA 60131890) |
| Enumeration Date | 2017-01-19 |
| Last Update Date | 2017-01-19 |