Individual
DENCEL RAY POLINTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 MASONIC WAY, SULLIVAN, IL 61951-9467
(217) 728-4394
Mailing address
117 W POLK AVE APT 15, CHARLESTON, IL 61920-2585
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.021659
IL
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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