| NPI | 1780392415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL GALLARDO Physical Therapist, Owner 815-622-8879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2022-11-10 |
| Last Update Date | 2022-11-10 |