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General NPI Number Information
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NPI Number | 1487891578
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Entity Type | Organization
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Legal Business Name | START2FINISH STUDIO
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Dates
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Enumeration Date | 01/13/2009
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Last Update Date | 01/13/2009
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Provider Practice Location Address
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Address Line | 708 VERNON AVE
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City | GLENCOE
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State | IL
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Zip | 60022-1531
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Country | US
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Telephone | 847-977-2420
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Fax |
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Provider Business Mailing Address
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Address Line | 708 VERNON AVE
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City | GLENCOE
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State | IL
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Zip | 60022-1531
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Country | US
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Telephone | 847-977-2420
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARK PAYARES
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Credential | DPT
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Telephone | 847-977-2420
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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 | 070016136
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License Number State | IL
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