| NPI | 1841336922 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN DAVID MATTSON LLC Manager 773-968-7871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: IL 056005768) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-02-06 |