Individual
NICHOLAS A BATHURST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
CARLE BROMENN MEDICAL CENTER, 1304 FRANKLIN AVE., NORMAL, IL 61761
(309) 454-1400
Mailing address
1604 VISA DR STE 1, NORMAL, IL 61761-2195
(309) 846-4716
(309) 454-7348
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
07/16/2021
Last updated
07/16/2021
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