Organization
LTZ PHYSICAL THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ZOSIMA ABIVA VICTUELLES RN (CHAIRMAN OF THE BOARD)
(630) 890-7530
Entity
Organization
Contact information
Practice address
4117 W SHAMROCK LN, MCHENRY, IL 60050-8289
(815) 601-4613
(815) 484-9226
Mailing address
4117 W SHAMROCK LN, MCHENRY, IL 60050-8289
(815) 601-4613
(815) 484-9226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
041326250
IL
Other
Enumeration date
01/01/2012
Last updated
02/21/2012
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