| Organization Name: | HR PHYSICAL THERAPY , SPORTS & INDUSTRIAL REHABILITATION PC |
| NPI Number: | 1265474555 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA L ROACH (PRESIDENT) |
| Mailing Address: | 3308 Logan Dr Herrin |
| State: | IL US |
| Postal Code: | 629483759 |
| Phone Number: | 6189934024 |
| Fax Number: | 6189931570 |
| NPI Enumeration Date: | 06/12/2006 |
| NPI Last Update Date: | 03/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251X0800X |
| License Number: | 070007595 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Orthopedic |
| Taxonomy Definition: | |