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General NPI Number Information
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NPI Number | 1386828267
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Entity Type | Organization
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Legal Business Name | SOUTHWEST PHYSICAL THERAPY AND REHABILIATION, LTD
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 04/30/2008
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Provider Practice Location Address
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Address Line | 111 W. JACKSON STREET
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City | MORRIS
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State | IL
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Zip | 60450-1845
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Country | US
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Telephone | 815-941-7777
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W. JACKSON STREET
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City | MORRIS
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State | IL
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Zip | 60450-1845
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Country | US
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Telephone | 815-941-7777
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | KATHLEEN M VAIL
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Credential | DPT
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Telephone | 708-499-4497
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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 | 060005170
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License Number State | IL
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