Individual
DANIEL RALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
405 W JACKSON ST, CARBONDALE, IL 62901-1462
(866) 916-5259
(231) 922-4030
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085004204
IL
Other
Enumeration date
10/18/2011
Last updated
09/28/2021
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