| NPI | 1902072523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIVA KUMAR MENON President 708-383-8705 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-008586) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: IL 070-008586) |
| Enumeration Date | 2008-05-03 |
| Last Update Date | 2008-05-03 |