| NPI | 1679631790 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARI S CASSIDY Secretary 815-469-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |