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Individual

JOHN H BULTHOUSE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
655 W LINCOLN AVE STE 8, CHARLESTON, IL 61920-2461
(217) 254-6582
Mailing address
311 W MAIN ST, OAKLAND, IL 61943-7109
(217) 512-9178

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
12/17/2020
Last updated
12/17/2020
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