Individual
MR. DOUGLAS JAMES WILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
325 N SAINT PAUL ST, SUITE 4200, DALLAS, TX 75201-3801
(866) 953-0011
(866) 953-0012
Mailing address
3510 LOWDEN ST, KALAMAZOO, MI 49008-2638
(269) 385-5999
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
86001508A
IN
Other
Enumeration date
03/31/2007
Last updated
07/08/2007
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