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Organization

EASTERN IOWA THERAPEUTICS PC

Active
Other names
Accelerated Rehabilitation Centers
Organization subpart
No

Provider details

NPI number
Authorized official
RANDOLPH P FRIESER PT (PRESIDENT SECRETARY)
(312) 640-0329
Entity
Organization

Contact information

Practice address
2406 MOMENTUM PL, CHICAGO, IL 60689-0001
(815) 577-2480
(815) 577-7535
Mailing address
205 W WACKER DR, SUITE 1020, CHICAGO, IL 60606-1216

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02757
IA
2251X0800X
Orthopedic Physical Therapist
IA
225X00000X
Occupational Therapist
IA
235Z00000X
Speech-Language Pathologist
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0429076
IA
05
0665026
IA
Enumeration date
05/26/2006
Last updated
10/16/2008
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