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General NPI Number Information
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NPI Number | 1952767451
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Entity Type | Organization
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Legal Business Name | HOUGLUM PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 01/13/2016
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Last Update Date | 01/13/2016
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Provider Practice Location Address
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Address Line | 1222 WASHINGTON CT SUITE 200
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City | WILMETTE
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State | IL
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Zip | 60091-2615
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Country | US
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Telephone | 847-251-1539
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Fax | 847-251-1539
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Provider Business Mailing Address
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Address Line | 1222 WASHINGTON CT SUITE 200
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City | WILMETTE
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State | IL
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Zip | 60091-2615
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Country | US
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Telephone | 847-251-1539
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Fax | 847-251-1539
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | DANIEL E. HOUGLUM
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Credential | MSPT, ATC/L
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Telephone | 262-909-4903
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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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