| NPI | 1922129352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SLAUGHTER Physical Therapist Owner 618-656-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070007731) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2008-02-01 |