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NPI Code Detail

MEDICARE: ALECIA GROUNDS PT

MEDICARE: ALECIA GROUNDS PT
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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1821384439
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALECIA GROUNDS PT
Provider Business Mailing Address
First Line : 1140 E ALGONQUIN RD
Second Line : DIAMOND PHYSICAL THERAPY
City : ALGONQUIN
State : IL
Zip : 60102-3084
Country : US
Telephone Number : 847-854-0196
Fax Number :
Provider Business Practice Location Address
First Line : 1728 N RICHMOND RD
Second Line :
City : MCHENRY
State : IL
Zip : 60051-5414
Country : US
Telephone Number : 815-578-8905
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2011
Last Update Date : 08/13/2015

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Directions to “ ALECIA GROUNDS PT” Practice Location

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