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Organization

BACK IN MOTION PHYSICAL THERAPY & SPINE CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SONIA M KWAPISINSKI DC (OWNER)
(815) 675-0699
Entity
Organization

Contact information

Practice address
2900 N US HIGHWAY 12 STE J, SPRING GROVE, IL 60081-8322
(815) 675-0699
(815) 675-0689
Mailing address
PO BOX 362, 2900 US HWY 12 SUITE J, SPRING GROVE, IL 60081-0362
(815) 675-0699
(815) 675-0689

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
IL
225100000X
Physical Therapist
Primary
70015875
IL
225100000X
Physical Therapist
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05632004
BLUE CROSS BLUE SHIELD
IL
01
1437205325
INDIVIDUAL NPI OF LPT
IL
01
1730371915
INDIVIDUAL NPI OF DPT
IL
01
1932214665
INDIVIDUAL NPI
IL
Enumeration date
04/13/2007
Last updated
03/04/2008
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