NPI | 1528652096 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN DAVID CHURCH Vice President Of Finance 618-972-5228 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 225100000X Physical Therapist |
225X00000X Occupational Therapist | |
235Z00000X Speech-Language Pathologist, | |
Enumeration Date | 2021-02-25 |
Last Update Date | 2024-09-23 |