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Organization
MIDWEST PHYSICAL THERAPY
Active
Organization
MIDWEST PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER SMITH (BILLING AGENT)
(815) 965-8505
Entity
Organization
Contact information
Practice address
513 4TH AVE, ROCHELLE, IL 61068-1510
(815) 561-8786
(815) 561-8786
Mailing address
513 4TH AVE, ROCHELLE, IL 61068-1510
(815) 561-8786
(815) 561-8786
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07132019
BCBS ID
IL
Enumeration date
01/15/2008
Last updated
01/15/2008
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