Organization
DECATUR ATHLETIC CLUB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICE YVONNE DANIELS (DIRECTOR OF POST REHABILITATION)
(217) 423-7020
Entity
Organization
Contact information
Practice address
1010 W SOUTH SIDE DR, DECATUR, IL 62521-4023
(217) 423-7020
(217) 423-7562
Mailing address
1010 W SOUTH SIDE DR, DECATUR, IL 62521-4023
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
06/30/2009
Last updated
06/30/2009
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