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General NPI Number Information
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NPI Number | 1174715650
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Entity Type | Organization
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Legal Business Name | ULTIMATE THERAPEUTIC SOLUTIONS, LLC
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 01/03/2008
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Provider Practice Location Address
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Address Line | 4343 STATE HIGHWAY 14
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City | CHRISTOPHER
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State | IL
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Zip | 62822
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Country | US
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Telephone | 618-724-7456
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Fax | 618-724-7492
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Provider Business Mailing Address
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Address Line | 101 PARK CIR
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City | BENTON
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State | IL
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Zip | 62812-3464
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Country | US
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Telephone | 618-724-7456
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Fax | 847-572-1158
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Authorized Official
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Title or Position | OWNER
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Name | BENJAMIN N RICE
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Credential |
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Telephone | 618-724-7456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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