Organization Name: | THERAKIDS, P.C. |
NPI Number: | 1366715328 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRUCE A HARTRICH (SECRETARY) |
Mailing Address: | 10354 Prairie Dell Rd Shipman |
State: | IL US |
Postal Code: | 626856105 |
Phone Number: | 6188367442 |
Fax Number: | |
NPI Enumeration Date: | 02/21/2012 |
NPI Last Update Date: | 02/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |