Individual
JOSIAH DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1500 SULLIVAN RD, AURORA, IL 60506-1067
(630) 907-5000
Mailing address
30 N BROADWAY UNIT B, AURORA, IL 60505-3312
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004760
IL
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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