Individual
KAMAL TEJ ANNAVARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2710 E LINCOLN ST STE A, BLOOMINGTON, IL 61704-6010
(309) 662-8418
(309) 662-8418
Mailing address
2710 E LINCOLN ST STE A, BLOOMINGTON, IL 61704-6010
(309) 662-8418
(309) 662-8418
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038014127
IL
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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