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General NPI Number Information
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NPI Number | 1528622263
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Entity Type | Organization
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Legal Business Name | PRECISION PERFORMANCE AND SPORTS MEDICINE
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Dates
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Enumeration Date | 04/29/2019
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Last Update Date | 11/04/2021
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Provider Practice Location Address
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Address Line | 1 S NORTHWEST HWY
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City | PARK RIDGE
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State | IL
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Zip | 60068-4240
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Country | US
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Telephone | 312-620-0902
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Fax |
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Provider Business Mailing Address
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Address Line | 3017 N MANGO AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5217
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Country | US
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Telephone | 312-576-0199
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER/PHYSICAL THERAPIST
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Name | DR. CHRISTINE DAVIS
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Credential | PT, DPT
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Telephone | 312-620-0902
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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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