| NPI | 1891052601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS CUSACK Operations Manager 224-392-4872 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NC 11158) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2012-07-05 |