NPI | 1588845804 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN R VAN SUSTEREN Physical Therapis / Owner 262-248-9902 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: WI 4467024) |
Enumeration Date | 2007-11-15 |
Last Update Date | 2010-04-07 |