MYOFASCIAL RELEASE OF SOUTHERN ILLINOIS
NPI 1851722946
Clinic/Center - Rehabilitation in Carbondale, IL

Q: What is Myofascial Release Of Southern Illinois's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.

Active since November 27, 2013

101 S GRAHAM AVE, SUITE 3, CARBONDALE, IL 62901(618) 305-4696(888) 975-0097 Get Directions Write a Review

NPPES record last updated: November 4, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Myofascial Release Of Southern Illinois NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYOFASCIAL RELEASE OF SOUTHERN ILLINOIS (NPI 1851722946) is a healthcare organization registered as a rehabilitation in Carbondale, Illinois and active in the NPI registry since November 2013. The organization lists Tara Manzano, President/occupational Therapist, as its authorized official.

NPPES Registry Identity

NPI1851722946

Entity TypeOrganization

Primary Taxonomy261QR0400X

Legal Business NameMYOFASCIAL RELEASE OF SOUTHERN ILLINOIS

Location Address101 S GRAHAM AVE, SUITE 3Carbondale, IL 62901-3043

Mailing Address101 S Graham Ave, Suite 3Carbondale, IL 62901-3043 · (618) 305-4696 · Fax (888) 975-0097

Phone(618) 305-4696

Fax(888) 975-0097

Organization SubpartNo

Authorized OfficialTara ManzanoPresident/occupational Therapist · (618) 305-4696

Enumeration DateNovember 27, 2013

Last NPPES UpdateNovember 4, 2014

✔ NPI 1851722946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RehabilitationAmbulatory Health Care Facilities

Taxonomy Code261QR0400X

License✔ Licensed in IL · 248.000873

101 S GRAHAM AVE, Carbondale, IL 62901

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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. TARA MANZANO OTR/L

Occupational Therapist

101 S GRAHAM AVE, SUITE 3
CARBONDALE, IL 62901

Jackson County (618) 305-4696

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Myofascial Release Of Southern Illinois's NPI number?

The NPI number for Myofascial Release Of Southern Illinois is 1851722946. It was assigned to this organization in the NPPES registry on November 27, 2013.

Where is Myofascial Release Of Southern Illinois located?

Myofascial Release Of Southern Illinois is located at 101 S Graham Ave Suite 3, Carbondale, IL 62901. The listed phone number is (618) 305-4696.

What is Myofascial Release Of Southern Illinois's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, with taxonomy code 261QR0400X.

When was this NPI record last updated?

The NPPES record for Myofascial Release Of Southern Illinois was last updated on November 4, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.