Myofascial Release of Southern Illinois
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 3Carbondale, IL 62901-3043
Phone: (618) 305-4696
Fax: (888) 975-0097
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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 number | 1851722946 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Tara Manzano — President/Occupational Therapist · (618) 305-4696 |
| NPI enumerated | November 27, 2013 |
| Last updated in NPPES | November 4, 2014 |
| Mailing address | 101 S Graham Ave, Suite 3, Carbondale, IL 62901-3043 |
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