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NPI Code Detail

MEDICARE: HEADWIND HEALTH LLC

MEDICARE: HEADWIND HEALTH LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center

General Provider Information

NPI Number : 1184397614
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEADWIND HEALTH LLC
Provider Business Mailing Address
First Line : 1224 W TAYLOR ST APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60607-4709
Country : US
Telephone Number : 937-903-4837
Fax Number :
Provider Business Practice Location Address
First Line : 1224 W TAYLOR ST APT 2
Second Line :
City : CHICAGO
State : IL
Zip : 60607-4709
Country : US
Telephone Number : 937-903-4837
Fax Number :
Authorized Official
Title or Position : CEO
Name : BRYCE RENICKER
Credential : PT, DPT
Telephone Number : 937-903-4837
Provider Enumeration Date : 07/29/2021
Last Update Date : 07/29/2021

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Directions to “HEADWIND HEALTH LLC ” Practice Location

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