| Organization Name: | BREFELD PHYSICAL THERAPY SERVICES PC |
| NPI Number: | 1053308015 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOAN L BREFELD (PRESIDENT) |
| Mailing Address: | 106 Lincoln Place Ct Belleville |
| State: | IL US |
| Postal Code: | 622215884 |
| Phone Number: | 6182367588 |
| Fax Number: | 6182367589 |
| NPI Enumeration Date: | 10/04/2005 |
| NPI Last Update Date: | 11/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |