Organization
HERITAGE ENTERPRISES, INC.
Active
Other names
Heritage Enterprises, Inc. dba Green Tree Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID M UNDERWOOD (SR. VP & CFO)
(309) 828-4361
Entity
Organization
Contact information
Practice address
700 E WALNUT ST, BLOOMINGTON, IL 61701-3244
(309) 829-1268
(309) 829-3475
Mailing address
115 W JEFFERSON ST, SUITE 401, BLOOMINGTON, IL 61701-3946
(309) 828-4361
(309) 829-9512
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
-61702-17
IL
Other
Enumeration date
11/02/2005
Last updated
07/21/2022
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