| NPI | 1841930351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN A RYAN-CEISEL Owner 224-505-3343 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |