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Individual

MR. JAMES BRYAN FOUNTAIN II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
2320 W JEFFERSON ST, JOLIET, IL 60435-6427
(815) 741-3758
(815) 741-3974
Mailing address
2320 W JEFFERSON ST, JOLIET, IL 60435-6427
(815) 741-3758
(815) 741-3974

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160.008370
IL

Other

Enumeration date
12/08/2023
Last updated
12/08/2023
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