NPI | 1861668956 |
---|---|
Entity Type | Organization |
Authorized Contact | VALERIE MILLER Physical Therapist 815-405-7990 |
Organization Subpart ? | No |
Primary Taxonomy | 252Y00000X Early Intervention Provider Agency (Licence: IL 070.010384) |
Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
Enumeration Date | 2008-05-08 |
Last Update Date | 2025-02-28 |