Individual
PADRAIC HARTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1430 TRUMBULL AVE, APT 2, NORMAL, IL 61761-9488
(708) 305-0690
Mailing address
1430 TRUMBULL AVE, APARTMENT 2, NORMAL, IL 61761-9488
(708) 305-0690
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004504
IL
246Z00000X
Other Specialist/Technologist
—
IL
Other
Enumeration date
04/24/2017
Last updated
09/25/2017
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