Individual
DOMINGO GRULLON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
11275 DELAWARE PKWY STE B, CROWN POINT, IN 46307-7812
(219) 663-8766
Mailing address
6050 TACOMA MALL BLVD STE 300, TACOMA, WA 98409-6828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA02192500
NY
225100000X
Physical Therapist
CP035073T
VA
Other
Enumeration date
08/09/2023
Last updated
10/17/2024
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