Organization
MODERN ATHLETE PHYSICAL THERAPY LLC
Active
Organization
MODERN ATHLETE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL TODD BITZER PT (OWNER, PHYSICAL THERAPIST)
(847) 257-5172
Entity
Organization
Contact information
Practice address
1033 PROGRESS DR, GRAYSLAKE, IL 60030-1672
(847) 257-5172
Mailing address
32 LYNN DR, HAWTHORN WOODS, IL 60047-9102
(847) 257-5172
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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