Jon Michael Berena Valid NPI

Individual provider · Physical Therapy Assistant · Des Plaines, IL

NPI

1174103931

Type

Individual (Type 1)

Primary specialty

Physical Therapy Assistant

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225200000X

License number

160009038 (IL)

Sex

Male

Sole proprietor

Yes

Enumerated

2021-04-14

Last updated

2021-04-14