| NPI | 1639735418 |
|---|---|
| Doing Business As | PANOPTIC PHYSICAL THERAPY - BOURBONNAIS |
| Entity Type | Organization |
| Authorized Contact | GERALD EDWARD MERTES Chief Operating Officer 815-513-3298 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |