Individual
DOUGLAS JOHN BULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 ASH DR, COLONA, IL 61241-9549
(309) 269-4797
Mailing address
900 ASH DR, COLONA, IL 61241-9549
(309) 269-4797
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160006597
IL
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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