Organization
VITALREHAB PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY BURK (CONSULTANT)
(309) 310-9610
Entity
Organization
Contact information
Practice address
1015 S MERCER AVE, BLOOMINGTON, IL 61701-7107
(309) 310-9610
Mailing address
1701 E EMPIRE ST, STE 360-BOX 294, BLOOMINGTON, IL 61704
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
10/11/2017
Last updated
10/11/2017
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