NPI | 1619039724 |
---|---|
Other Name | SAMG BROOKSIDE |
Entity Type | Organization |
Authorized Contact | DON DANIELS VP 815-966-2084 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2006-12-14 |
Last Update Date | 2013-07-30 |