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NPI Code Detail

MEDICARE: WHOLE BODY, LLC

MEDICARE: WHOLE BODY, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1477110393
Entity Type Code : Organization
Provider Name (Legal Business Name) : WHOLE BODY, LLC
Provider Business Mailing Address
First Line : 7 JUNCTION DR STE 257
Second Line :
City : GLEN CARBON
State : IL
Zip : 62034-4300
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 535 EDWARDSVILLE RD STE 220
Second Line :
City : TROY
State : IL
Zip : 62294-1399
Country : US
Telephone Number : 618-967-5539
Fax Number :
Authorized Official
Title or Position : OWNER/PHYSICAL THERAPIST
Name : MRS. REBECCA WILLMANN-ALBRECHT
Credential : MPT
Telephone Number : 618-967-5539
Provider Enumeration Date : 05/27/2019
Last Update Date : 05/27/2019

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Directions to “WHOLE BODY, LLC ” Practice Location

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