Individual
MR. JERICHO A CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
3741 S WICKENS ST, BLOOMINGTON, IN 47403-4595
(812) 272-6515
Mailing address
3741 S WICKENS ST, BLOOMINGTON, IN 47403-4595
(812) 272-6515
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008341A
IN
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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