| NPI | 1538183975 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANA GRANADOS Authorized Official 630-575-1980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 3616) |
| Additional Taxonomies | 2251E1200X Physical Therapist, Ergonomics (Licence: AZ 3616) |
| 2251H1200X Physical Therapist, Hand (Licence: AZ 5259) | |
| 2251S0007X Physical Therapist, Sports (Licence: AZ 3616) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2019-03-22 |