Organization
DYNAMIC PHYSIOTHERAPY SERVICES CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WITOLD MIERZWA LPT (OWNER)
(773) 354-3063
Entity
Organization
Contact information
Practice address
4601 W 103RD ST, OAK LAWN, IL 60453-4718
(708) 422-3422
Mailing address
601 S ADAMS ST, WESTMONT, IL 60559-2206
(773) 354-3063
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
12/04/2012
Last updated
01/28/2019
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