Provider Demographics
NPI:1992342851
Name:INLINE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:INLINE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:618-881-0909
Mailing Address - Street 1:102 GREENVIEW DR
Mailing Address - Street 2:
Mailing Address - City:EFFINGHAM
Mailing Address - State:IL
Mailing Address - Zip Code:62401-3048
Mailing Address - Country:US
Mailing Address - Phone:618-881-0909
Mailing Address - Fax:618-881-0910
Practice Address - Street 1:102 GREENVIEW DR
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-3048
Practice Address - Country:US
Practice Address - Phone:618-881-0909
Practice Address - Fax:618-881-0910
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INLINE PHYSICAL THERAPY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-10
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty