Organization
ADVANCE SPORTS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AZLAAN ARIF (OWNER)
(630) 708-8778
Entity
Organization
Contact information
Practice address
800 W 5TH AVE, SUITE 100G, NAPERVILLE, IL 60563-8965
(630) 708-8778
Mailing address
800 W 5TH AVE, SUITE 100G, NAPERVILLE, IL 60563-8965
(630) 708-8778
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
227012530
IL
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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