Organization
PHYSICAL THERAPISTS CLINIC,LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL DIANE BARBER (INSURANCE ADMINISTRATOR)
(217) 245-1455
Entity
Organization
Contact information
Practice address
1440 W WALNUT ST, SUITE 2, JACKSONVILLE, IL 62650-1143
(217) 245-1455
(217) 243-6903
Mailing address
1440 W WALNUT ST, SUITE 2, JACKSONVILLE, IL 62650-1143
(217) 245-1455
(217) 243-6903
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0005415281
BCBS
IL
01
—
141-989
HEALTHLINK
IL
Enumeration date
03/29/2007
Last updated
07/16/2008
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