Organization
LEGACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PARVIZ AYREMPOUR PTA (PHYSICAL THERAPIST ASSISTANT)
(847) 670-7214
Entity
Organization
Contact information
Practice address
120 SOUTH HI LUSI AVE, MOUNT PROSPECT, IL 60056
(847) 670-7214
Mailing address
120 SOUTH HI LUSI AVE, MOUNT PROSPECT, IL 60056
(847) 670-7214
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
160.002590
IL
Other
Enumeration date
10/18/2010
Last updated
10/18/2010
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