Individual
MR. JASON EMIL WULF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LATC, CSCS
Contact information
Practice address
211 HORTON FIELDHOUSE, NORMAL, IL 61790-0001
(309) 438-3284
Mailing address
1216 SEARLE DR, NORMAL, IL 61761-2867
(309) 452-8352
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
96002168
IL
Other
Enumeration date
03/14/2006
Last updated
07/08/2007
About Stedi
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