Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1013972694 |
---|---|
Provider Name | Mr. Joseph S Neczek |
First Address | Lombard, IL 60148-2530 |
Second Address | Hines, IL 60141 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 08/07/2007 |