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Organization

INTUITIVE BODY THERAPEUTICS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINA SEROCKE MOT, OTR/L, CEAS (OCCUPATIONAL THERAPIST)
(708) 714-1911
Entity
Organization

Contact information

Practice address
8257 W MAPLE AVE, NORRIDGE, IL 60706-4329
(708) 714-1911
Mailing address
8257 W MAPLE AVE, NORRIDGE, IL 60706-4329
(708) 714-1911

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1215289814
PERSONAL
IL
Enumeration date
09/05/2017
Last updated
09/05/2017
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