Provider Demographics
NPI:1235908898
Name:PRECISION PHYSCIAL THERAPY SPECIALISTS, PLLC
Entity Type:Organization
Organization Name:PRECISION PHYSCIAL THERAPY SPECIALISTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:763-360-1823
Mailing Address - Street 1:20632 S IVY PATH
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-8742
Mailing Address - Country:US
Mailing Address - Phone:763-360-1823
Mailing Address - Fax:708-810-8686
Practice Address - Street 1:20632 S IVY PATH
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-8742
Practice Address - Country:US
Practice Address - Phone:763-360-1823
Practice Address - Fax:708-810-8686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy