Individual
MR. JESUS JOEL GULOY MANAGUELOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008180
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
056.008180
LICENSE
IL
Enumeration date
06/04/2008
Last updated
10/20/2016
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