| NPI | 1609010545 |
|---|---|
| Former Legal Business Name | A BIG BLAST, INC |
| Entity Type | Organization |
| Authorized Contact | RHONDA PENZELL President 847-650-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2009-04-22 |
| Last Update Date | 2011-05-06 |