| NPI | 1750335329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY NEWMAN Com PT Roller 815-227-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME 93347) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH 8788) |
| 225100000X Physical Therapist (Licence: FL PT20245) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2020-08-22 |