Provider Demographics
NPI:1528766185
Name:FERRARI PHYSICAL THERAPY P.L.L.C.
Entity type:Organization
Organization Name:FERRARI PHYSICAL THERAPY P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTORATE OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:EDOARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARI
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:618-789-5042
Mailing Address - Street 1:18 HERITAGE TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:MORO
Mailing Address - State:IL
Mailing Address - Zip Code:62067
Mailing Address - Country:US
Mailing Address - Phone:618-789-5042
Mailing Address - Fax:
Practice Address - Street 1:6189 BENNETT DR SUITE C
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025
Practice Address - Country:US
Practice Address - Phone:618-789-5042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy