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General NPI Number Information
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NPI Number | 1730683582
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Entity Type | Organization
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Legal Business Name | PELVIC BALANCE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 03/19/2018
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Last Update Date | 03/19/2018
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Provider Practice Location Address
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Address Line | 10 N COLLINS ST.
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City | SOUTH ELGIN
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State | IL
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Zip | 60177
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Country | US
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Telephone | 847-220-4998
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Fax |
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Provider Business Mailing Address
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Address Line | 10 N COLLINS ST.
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City | SOUTH ELGIN
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State | IL
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Zip | 60177
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Country | US
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Telephone | 847-220-4998
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/ OWNER
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Name | APRIL GUTIERREZ
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Credential |
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Telephone | 847-347-1090
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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 | 070.015375
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License Number State | IL
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