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General NPI Number Information
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NPI Number | 1033522362
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Entity Type | Organization
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Legal Business Name | STARTING SMART LLC
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Dates
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Enumeration Date | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 3359 N SEMINARY AVE # 1
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City | CHICAGO
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State | IL
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Zip | 60657-2220
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Country | US
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Telephone | 248-819-0771
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Fax | 773-697-4611
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Provider Business Mailing Address
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Address Line | 3359 N SEMINARY AVE # 1
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City | CHICAGO
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State | IL
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Zip | 60657-2220
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Country | US
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Telephone | 248-819-0771
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Fax | 773-697-4611
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Authorized Official
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Title or Position | OWNER, PHYSICAL THERAPIST
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Name | KATHLEEN M HENRY
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Credential | PT, DPT
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Telephone | 248-819-0771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 070017402
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License Number State | IL
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