| NPI | 1730414699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALDO BASTO COLOMA President 815-409-8301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070014683) |
| Enumeration Date | 2009-10-11 |
| Last Update Date | 2010-05-25 |