| NPI | 1720103872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN MARGARET KLEBER Owner 217-337-4313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: IL 096.001528) |
| 225700000X Massage Therapist (Licence: IL 227.001883) | |
| 226300000X Kinesiotherapist (Licence: IL 1290) | |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2017-02-03 |