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General NPI Number Information
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NPI Number | 1578035994
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Entity Type | Organization
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Legal Business Name | BODY IN SYNC PHYSICAL THERAPY, LTD.
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Dates
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Enumeration Date | 12/24/2018
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Last Update Date | 12/24/2018
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Provider Practice Location Address
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Address Line | 19815 S LA GRANGE RD
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City | MOKENA
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State | IL
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Zip | 60448-8348
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Country | US
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Telephone | 779-803-2014
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Fax |
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Provider Business Mailing Address
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Address Line | 7411 W HICKORY CREEK DR
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City | FRANKFORT
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State | IL
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Zip | 60423-9099
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Country | US
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Telephone | 779-803-2014
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VALERIE ALYSE WILLIAMS
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Credential | PT, DPT
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Telephone | 779-803-2014
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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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