| NPI | 1861757361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVE HAYES Administrator 618-826-4581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070.018968) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |