| NPI | 1538534359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER FONG Member 312-403-1853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: IL 070013559) |
| Additional Taxonomies | 171100000X Acupuncturist |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-08 |