| NPI | 1780825455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AARON W FUERST Owner 815-549-6587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070012917) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2010-07-14 |