Organization
HEALTHY CONNECTION PHYSICAL MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR PUODZIUNAS (TREASURER)
(815) 834-9075
Entity
Organization
Contact information
Practice address
16626 W 159TH ST, SUITE700, LOCKPORT, IL 60441-8018
(815) 834-9075
(815) 834-9077
Mailing address
16626 W 159TH ST, SUITE700, LOCKPORT, IL 60441-8018
(815) 834-9075
(815) 834-9077
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036126664
IL
Other
Enumeration date
11/14/2011
Last updated
08/13/2013
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