Organization
PHOENIX UNDERGROUND PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW MCGUIRE DPT (OWNER)
(608) 217-6841
Entity
Organization
Contact information
Practice address
1142 W NORTH SHORE AVE APT 3N, CHICAGO, IL 60626-4640
(608) 217-6841
Mailing address
1142 W NORTH SHORE AVE APT 3N, CHICAGO, IL 60626-4640
(608) 217-6841
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
070018695
IL
Other
Enumeration date
03/18/2016
Last updated
03/18/2016
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