| NPI | 1558538967 |
|---|---|
| Other Name | WESLEY WILLOWS OUTPATIENT REHAB CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARK A TICKNOR CFO 815-316-1518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2008-05-14 |
| Last Update Date | 2008-05-14 |