Organization Name: | WEST PHYSICAL THERAPY P C |
NPI Number: | 1659345262 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JULIE A WEST (OWNER) |
Mailing Address: | 38 S Main St Suite A & B Sugar Grove |
State: | IL US |
Postal Code: | 605545031 |
Phone Number: | 6304665866 |
Fax Number: | 6304665869 |
NPI Enumeration Date: | 02/13/2006 |
NPI Last Update Date: | 06/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 060-008969 70-005680 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |