Sports Medicine Clinic Of Macon County

NPI 1174594717 - Physical Therapist - 225100000X

NPI Details
NPI 1174594717
Enumeration Date 01/31/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name ROBERT W ROBERT
Position OWNER, CEO
Phone (217) 428-6222
Fax (217) 428-2617
Practice Location
1900 E LAKE SHORE DR
SUITE 150
DECATUR IL, 62521-3824, US
Phone (217) 428-6222
Fax (217) 428-2617
Business Location
1900 E LAKE SHORE DR
SUITE 150
DECATUR IL, 62521-3824, US
Phone (217) 428-6222
Fax (217) 428-2617
Toxanomy
Taxonomy Code 225100000X
License State
License Number
Remove 1174594717 NPI Number
 

According to our database, Sports Medicine Clinic Of Macon County NPI is 1174594717, taxonomy code is 225100000X Sports Medicine Clinic Of Macon County physically located at 1900 E Lake Shore Dr, Decatur IL, 62521-3824. NPI Number 1033115704 has the healthcare provider type.

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1174594717 NPI number is provided on an as is basis without warranty of any kind. 1174594717 is maintained by the National Plan & Provider Enumeration System. The contents of Sports Medicine Clinic Of Macon County are for informational purposes only.