Avamere Outpatient Services

NPI #1548404767 in Woodstock, Illinois

Provider Information

NPI Number: 1548404767
Entity Type: Organization
Organization Name: Avamere Outpatient Services
Primary Specialty: Physical Therapist
Enumeration Date: May 1, 2009
Last Updated: May 1, 2009

Practice Location

Address: 318 CHRISTIAN WAY
City: Woodstock
State: Illinois
ZIP Code: 60098-2912
Phone: (815) 338-1749

Authorized Official

Name: MARK COWAN
Title: VICE PRESIDENT
Phone: (360) 608-7957

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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