| NPI | 1518638402 |
|---|---|
| Doing Business As | FUNCTIONAL HEALTH KENOSHA |
| Entity Type | Organization |
| Authorized Contact | NICOLE GRACE YULE Owner/Practitioner 630-863-6694 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2021-09-21 |
| Last Update Date | 2021-09-21 |