| NPI | 1710965918 |
|---|---|
| Doing Business As | PARA'S PEACH TREE |
| Entity Type | Organization |
| Authorized Contact | SHAUNA J RUZICH President/Clinical Manager 815-725-9992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225700000X Massage Therapist | |
| 225X00000X Occupational Therapist (Licence: IL 056002291) | |
| 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: IL 217000179) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IL 146006731) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IN 22003708A) | |
| Enumeration Date | 2006-01-06 |
| Last Update Date | 2020-08-22 |