Provider First Line Business Practice Location Address:
18636 DIXIE HWY
Provider Second Line Business Practice Location Address:
THERAPY PROVIDERS SOUTH
Provider Business Practice Location Address City Name:
HOMEWOOD
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60430-3741
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-922-0400
Provider Business Practice Location Address Fax Number:
708-922-0330
Provider Enumeration Date:
02/12/2007