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Organization
SPINAE VITAE PHYSICAL THERAPY PC
Active
Organization
SPINAE VITAE PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELZBIETA WIERZCHON-MROZ P.T. (OWNER/PRESIDENT)
(847) 251-9790
Entity
Organization
Contact information
Practice address
1225 GREEN BAY RD, WILMETTE, IL 60091-1643
(847) 251-9790
(847) 251-9792
Mailing address
1225 GREEN BAY RD, WILMETTE, IL 60091-1643
(847) 251-9790
(847) 251-9792
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-007485
IL
Other
Enumeration date
07/08/2006
Last updated
09/25/2009
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