Myofascial Release Of Southern Illinois

LBN: Myofascial Release Of Southern Illinois
Myofascial Release Of Southern Illinois is an health care organization with primary practice located at 101 S Graham Ave Suite 3, Carbondale IL 62901-3043. The organization recently has only one registered license in Ambulatory Health Care Facilities / Rehabilitation, which is considered as the primary health care specialty. Myofascial Release Of Southern Illinois can be contacted via phone (618) 305-4696, or through Manzano, Tara via phone (618) 305-4696.

Contact Information

Primary practice address
101 S Graham Ave Suite 3 Carbondale IL 62901-3043
Phone: (618) 305-4696
Fax: (888) 975-0097
Website:
Map and Directions
Authorized official contact:
Name: Manzano, Tara OTR/L
Phone: (618) 305-4696

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X 248.000873 Illinois

Profile Details

NPI number 1851722946
LBN Legal business name Myofascial Release Of Southern Illinois
DBA Doing business as
Authorized official Manzano, Tara OTR/L
Entity Organization
Organization subpart 1 No
Enumeration date Nov 27th, 2013
Last updated Nov 4th, 2014 - about 12 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Popular Providers