Individual
ROBERT MCNULTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
1313 CRANE BLVD, LIBERTYVILLE, IL 60048
(847) 421-4282
Mailing address
1528 SHINING ARMOR LN, WEST LAFAYETTE, IN 47906-5475
(847) 421-4282
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7035
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
11/02/2015
Last updated
07/27/2023
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