Individual
MR. JOAHNES PUNAY GATDULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1005 BROADWAY ST, QUINCY, IL 62301-2834
(217) 223-8400
(217) 223-9945
Mailing address
PO BOX 7005, 14TH AND BROADWAY, QUINCY, IL 62305-7005
(217) 223-8400
(217) 223-9945
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056008449
IL
225X00000X
Occupational Therapist
237044
ZZ
225X00000X
Occupational Therapist
974
ZZ
225X00000X
Occupational Therapist
OT4721
ZZ
Other
Enumeration date
10/27/2009
Last updated
10/29/2009
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