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General NPI Number Information
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NPI Number | 1477110393
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Entity Type | Organization
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Legal Business Name | WHOLE BODY, LLC
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Dates
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Enumeration Date | 05/27/2019
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Last Update Date | 05/27/2019
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Provider Practice Location Address
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Address Line | 535 EDWARDSVILLE RD STE 220
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City | TROY
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State | IL
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Zip | 62294-1399
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Country | US
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Telephone | 618-967-5539
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Fax |
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Provider Business Mailing Address
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Address Line | 7 JUNCTION DR STE 257
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City | GLEN CARBON
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State | IL
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Zip | 62034-4300
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | MRS. REBECCA WILLMANN-ALBRECHT
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Credential | MPT
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Telephone | 618-967-5539
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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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