NPI 1083187553

Active Life Spine & Joint Clinic LLC

Organisation Physical Therapist Rockford, IL

Practice location

Address: 3600 E State St STE 222, Rockford, IL 61108-1956
Phone: (224) 425-0548

Authorised official

Name: Ronald Samaniego
Title: Owner
Phone: (224) 425-0548

Registered specialties

Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225100000X

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Registry record

NPI: 1083187553
Entity type: Organization
NPI issued: 8 Jan 2019
Record last updated: 8 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.