Organization
INNOVATIVE SPORTS MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC HESTRUP D.C. (MEMBER)
(630) 788-7990
Entity
Organization
Contact information
Practice address
501 W FABYAN PKWY, BATAVIA, IL 60510-1267
(630) 524-2445
Mailing address
501 W FABYAN PKWY, BATAVIA, IL 60510-1267
(630) 524-2445
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011756
IL
225100000X
Physical Therapist
070019008
IL
Other
Enumeration date
12/15/2011
Last updated
05/22/2013
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