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Organization

SMITH PHYSICAL THERAPY AND RUNNING ACADEMY, LLC

Active
Other names
Smith Physical Therapy; Smith Running Academy
Organization subpart
No

Provider details

NPI number
Authorized official
DENISE FONTANA SMITH PT (PHYSICAL THERAPIST; OWNER)
(815) 893-9075
Entity
Organization

Contact information

Practice address
215 EXCHANGE DR, SUITE E, CRYSTAL LAKE, IL 60014-6206
(815) 893-9075
Mailing address
215 EXCHANGE DR, SUITE E, CRYSTAL LAKE, IL 60014-6206
(815) 893-9075

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
248001268
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1801989819
UNKNOWN
IL
Enumeration date
11/19/2015
Last updated
04/25/2017
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