| NPI | 1861810228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASEY KETELSEN Owner 309-433-3273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070016508) |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |