Organization
FREEFORM PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OMER AGUILAR (PHYSICAL THERAPIST)
(773) 301-3735
Entity
Organization
Contact information
Practice address
2906 W FULLERTON AVE, CHICAGO, IL 60647-2921
(773) 301-3735
Mailing address
2906 W FULLERTON AVE, CHICAGO, IL 60647-2921
(773) 301-3735
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
05/19/2020
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