| NPI | 1922567809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JOHN RANDA Owner 630-664-6298 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2021-12-02 |