| NPI | 1669138319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAYLA ELIZABETH ROTH Physical Therapist/Owner 815-973-4189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2023-11-15 |