Organization
PANOPTIC PHYSICAL THERAPY LLC
Active
Organization
PANOPTIC PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY LUKE PANOZZO JR. SLP (PRESIDENT)
(815) 513-3298
Entity
Organization
Contact information
Practice address
1511 N CONVENT ST STE 1000, BOURBONNAIS, IL 60914-1497
(815) 401-5102
(815) 401-5103
Mailing address
1802 NORTH DIVISION STREET, SUITE 202, MORRIS, IL 60450
(815) 513-3298
(815) 513-5446
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
04/03/2019
Last updated
12/05/2019
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