Southwest Sports & Spinal Rehab INC

NPI #1427309434 in Tinley Park, Illinois

Provider Information

NPI Number: 1427309434
Entity Type: Organization
Organization Name: Southwest Sports & Spinal Rehab INC
Primary Specialty: Chiropractor
Enumeration Date: Oct 1, 2012
Last Updated: Oct 1, 2012

Practice Location

Address: 16532 OAK PARK AVE STE 100
City: Tinley Park
State: Illinois
ZIP Code: 60477-2268
Phone: (708) 532-0000

Authorized Official

Name: DR. YELENA Y POTEKHINA
Title: PRESIDENT
Phone: (708) 532-0000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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