| |
15617 Cabrillo Way, Austin, TX 78738-6187 | |
(815) 409-1772 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Physical Therapist - Orthopedic |
Location | 15617 Cabrillo Way, Austin, Texas |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1356982268 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
2251X0800X | Physical Therapist - Orthopedic | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
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790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | 15617 Cabrillo Way, Austin, TX 78738-6187 Ph: (815) 409-1772 |