| NPI | 1720846082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY GRYLLS Billing/Credentialing 773-849-7723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2026-06-26 |