Individual
TOR ALEKSANDER ULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MOTR/L
Contact information
Practice address
3101 FIELDS SOUTH DR, CHAMPAIGN, IL 61822-3743
(217) 366-1323
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3909
(217) 366-1323
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
171754
KY
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
056014928
IL
225XP0019X
Physical Rehabilitation Occupational Therapist
OT-2724
NV
225XP0019X
Physical Rehabilitation Occupational Therapist
OT.0004668
CO
Other
Enumeration date
12/13/2016
Last updated
09/22/2022
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