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General NPI Number Information
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NPI Number | 1578990446
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Entity Type | Organization
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Legal Business Name | ASSESS, TREAT & CONDITION
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Dates
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Enumeration Date | 10/08/2013
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 611 N SPRINGER ST
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City | CARBONDALE
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State | IL
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Zip | 62901-1333
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Country | US
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Telephone | 618-559-8196
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Fax |
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Provider Business Mailing Address
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Address Line | 611 N SPRINGER ST
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City | CARBONDALE
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State | IL
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Zip | 62901-1333
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Country | US
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Telephone | 618-559-8196
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REHABILITATION & SPORTS
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Name | STEVE MIDDLETON
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Credential | ATC
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Telephone | 618-559-8196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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