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Individual

DANIEL PULLIAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
4005 RIPA AVE, SAINT LOUIS, MO 63125-2378
(314) 544-1111
Mailing address
5751 LANSDOWNE AVE, SAINT LOUIS, MO 63109-1529
(314) 609-7406

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary

Other

Enumeration date
11/15/2018
Last updated
11/15/2018
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