| NPI | 1679168751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY GOLDSTEIN Physical Therapist 224-300-6158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2021-03-01 |
| Last Update Date | 2021-04-07 |