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Organization
KINETIC REHAB LLC
Active
Organization
KINETIC REHAB LLC
Active
Other names
Cork Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY M RHOADS (OFFICE MANAGER)
(217) 826-2365
Entity
Organization
Contact information
Practice address
410 N 2ND ST, MARSHALL, IL 62441-1010
(217) 826-2365
(217) 826-8120
Mailing address
PO BOX 40, 410 N SECOND STREET, MARSHALL, IL 62441-0040
(217) 826-2365
(217) 826-8120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070002318
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1232012
BLUE CROSS KINETIC
IL
Enumeration date
11/09/2009
Last updated
03/05/2010
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