| NPI | 1598262057 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL MANNAN SHAMSUDDIN Owner 224-595-1631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070023234) |
| Enumeration Date | 2018-04-11 |
| Last Update Date | 2018-04-11 |