| NPI | 1942379110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL EDWARD KEENUM Owner President 708-366-2442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IL 070-002498) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |