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General NPI Number Information
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NPI Number | 1043804982
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Entity Type | Organization
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Legal Business Name | VHAB LLC
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Dates
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Enumeration Date | 02/22/2021
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 405 N WALOOSH AVE APT 1203
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 312-586-7574
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Fax |
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Provider Business Mailing Address
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Address Line | 405 NORTH MABASH AVENUE 1203
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City | CHICAGO
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State | IL
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Zip | 60611
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Country | US
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Telephone | 702-281-2815
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | VANESSA MARTIN
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Credential |
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Telephone | 312-586-7574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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