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Organization
ALLSTAR PHYSICAL THERAPY, LLC
Active
Organization
ALLSTAR PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY SCOTT ZICKUS P.T. (MANAGER)
(314) 603-8299
Entity
Organization
Contact information
Practice address
221 W POINTE DR, SUITE 1, SWANSEA, IL 62226-8306
(618) 416-6500
(618) 416-6503
Mailing address
221 W POINTE DR, SUITE 1, SWANSEA, IL 62226-8306
(618) 416-6500
(618) 416-6503
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
03/17/2011
Last updated
11/01/2011
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