Doctor Name: | BROCK WAYNE ATHEY |
NPI Number: | 1609152735 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPT |
License Number: | 070018141 |
Business Practice Address: | 1303 W Evergreen Ave Biomax Ste 102 Effingham, IL - 62401 |
Business Phone Number: | 2173433400 |
Business Fax Number: | 2173429714 |
Mailing Address: | 1303 W Evergreen Ave, Biomax Ste 102 EFFINGHAM |
State: | IL |
Postal Code: | 62401 |
Phone Number: | 2173433400 |
Fax Number: | 2173429714 |
NPI Enumeration Date: | 11/03/2011 |
NPI Last Update Date: | 11/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 070018141 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |