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NPI Code Detail

MEDICARE: HANES PHYSICAL THERAPY, LTD.

MEDICARE: HANES PHYSICAL THERAPY, LTD.
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/Center070.013338IL

General Provider Information

NPI Number : 1700279130
Entity Type Code : Organization
Provider Name (Legal Business Name) : HANES PHYSICAL THERAPY, LTD.
Provider Business Mailing Address
First Line : 486 N MAIN ST
Second Line :
City : CANTON
State : IL
Zip : 61520-1828
Country : US
Telephone Number : 309-339-1808
Fax Number :
Provider Business Practice Location Address
First Line : 486 N MAIN ST
Second Line :
City : CANTON
State : IL
Zip : 61520-1828
Country : US
Telephone Number : 309-339-1808
Fax Number :
Authorized Official
Title or Position : PHYSICAL THERAPIST, OWNER
Name : MR. ADAM A. HANES
Credential : M.P.T.
Telephone Number : 309-339-1808
Provider Enumeration Date : 03/10/2015
Last Update Date : 03/10/2015

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Directions to “HANES PHYSICAL THERAPY, LTD. ” Practice Location

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