NPI | 1720448855 |
---|---|
Entity Type | Organization |
Authorized Contact | TRACI L LOPINA Owner/Manager 708-743-6619 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070.012932) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.007339) |
Enumeration Date | 2016-03-02 |
Last Update Date | 2016-12-11 |