OrganizationActive
Active Life Spine & Joint Clinic LLC
NPI 1083187553 · Physical Therapist · Rockford, IL
Provider details
- NPI number
- 1083187553
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Authorized official
- Ronald Samaniego, Owner
Practice location
3600 E State St Ste 222
Rockford, IL 61108-1956
Phone: (224) 425-0548
Mailing address
3600 E State St Ste 222
Rockford, IL 61108-1956
Registry dates
- Enumerated
- 2019-01-08
- Last updated
- 2019-01-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.