Individual
THOMAS BANGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 W PARK ST, URBANA, IL 61801-2529
(217) 383-3400
Mailing address
810 W ANTHONY DR, URBANA, IL 61802-7431
(217) 383-3400
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070021488
IL
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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