Provider Demographics
NPI:1578990446
Name:ASSESS, TREAT & CONDITION
Entity Type:Organization
Organization Name:ASSESS, TREAT & CONDITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REHABILITATION & SPORTS
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:MIDDLETON
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:618-559-8196
Mailing Address - Street 1:611 N SPRINGER ST
Mailing Address - Street 2:
Mailing Address - City:CARBONDALE
Mailing Address - State:IL
Mailing Address - Zip Code:62901-1333
Mailing Address - Country:US
Mailing Address - Phone:618-559-8196
Mailing Address - Fax:
Practice Address - Street 1:611 N SPRINGER ST
Practice Address - Street 2:
Practice Address - City:CARBONDALE
Practice Address - State:IL
Practice Address - Zip Code:62901-1333
Practice Address - Country:US
Practice Address - Phone:618-559-8196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation