Myofascial Therapy Center at Rockford, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0700002325 Issued in IL

Legal business name

MYOFASCIAL THERAPY CENTER AT ROCKFORD, LLC

Practice address

421 S Mulford Rd
Rockford, IL 61108-3009

Phone

(815) 399-5734

NPI assigned

Dec 11, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Carl Mark Patrnchak, PT

Title

Physical Therapist Owner

Phone

(815) 399-5734

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1841473014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083009",
            "telephone_number": "815-399-5734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083009",
            "telephone_number": "815-399-5734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOFASCIAL THERAPY CENTER AT ROCKFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "PATRNCHAK",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST OWNER",
        "authorized_official_telephone_number": "815-399-5734",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "0700002325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg Myer, N.P
• John Carlton Myers, M.D.
• Lance Avery Myers, D.C.
• Nicole Lynn Myers, LCPC
• Karyssa Myhres, BCBA
• Karin Myrvold, LPTA
• Mys - Rockford LLC
• Nadeem Hanif, M.D.S.C.
• Emily Michelle Nadolski
• Ehsun Naeem, MD

• Physical Therapist in Rockford, IL
• Providers in Rockford, IL by specialty
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.