Healthcare Provider Details
I. General information
NPI: 1861520983
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2007
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5616 W 95TH ST
OAK LAWN IL
60453-2343
US
IV. Provider business mailing address
2300 COIT RD SUITE 300
PLANO TX
75075-3768
US
V. Phone/Fax
- Phone: 708-422-0800
- Fax: 708-636-1112
- Phone: 469-467-8705
- Fax: 267-321-2550
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
S.
BINSTEIN
Title or Position: EXECUTIVE VICE PRESIDENT
Credential:
Phone: 610-644-7824