Organization Name: | TCM PHYSICAL THERAPY, INC. |
NPI Number: | 1093085060 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CONNIE MYJAK (PRESIDENT) |
Mailing Address: | 4421 S Nancy Dr Crystal Lake |
State: | IL US |
Postal Code: | 600146464 |
Phone Number: | 8152453845 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2012 |
NPI Last Update Date: | 01/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | 070.007032 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |