Organization
CITY CENTER PHYSICAL THERAPY - PERU, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY R SEMLOW PT (PHYSICAL THERAPIST)
(815) 722-1757
Entity
Organization
Contact information
Practice address
1627 4TH ST, PERU, IL 61354-3507
(815) 223-4479
(815) 223-4489
Mailing address
1627 4TH ST, PERU, IL 61354-3507
(815) 223-4479
(815) 223-4489
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05032048
BLUE CROSS BLUE SHIELD
IL
05
—
211359
—
IL
01
—
DO3556
RRMC
—
Enumeration date
01/18/2007
Last updated
03/25/2009
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