Individual
BRANDON DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2200 FORT JESSE RD STE 230, NORMAL, IL 61761-6291
(309) 661-6267
Mailing address
2200 FORT JESSE RD STE 230, NORMAL, IL 61761-6291
(309) 661-6267
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070023089
IL
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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