Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Myofascial Release of Southern Illinois

Organization Rehabilitation Clinic/Center · NPI 1851722946

Myofascial Release of Southern Illinois is a Rehabilitation Clinic/Center in Carbondale, Illinois. Licensed in Illinois. Registered with an NPI since 2013.

Licensed in
IL
In the registry since
2013

Practice location Address checks out

101 S Graham Ave Ste 3
Carbondale, IL 62901-3043
Phone: (618) 305-4696
Fax: (888) 975-0097
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rehabilitation Clinic/Center (primary) Taxonomy 261QR0400X · Licence 248.000873 (IL)

Record details

NPI number1851722946
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Tara Manzano — President/Occupational Therapist · (618) 305-4696
NPI enumeratedNovember 27, 2013
Last updated in NPPESNovember 4, 2014
Mailing address101 S Graham Ave, Suite 3, Carbondale, IL 62901-3043

Other providers in Carbondale