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Organization
R.A. PHYSICAL THERAPY, PC
Active
Organization
R.A. PHYSICAL THERAPY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RHODORA BAUTISTA ASTRONOMO PT (PRESIDENT)
(217) 784-8033
Entity
Organization
Contact information
Practice address
109 N SANGAMON AVE, GIBSON CITY, IL 60936-1342
(217) 784-8033
(217) 784-8077
Mailing address
109 N SANGAMON AVE, GIBSON CITY, IL 60936-1342
(217) 784-8033
(217) 784-8077
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
319929929001
—
IL
Enumeration date
05/24/2006
Last updated
04/20/2008
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