Individual
MR. ALEX MORALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
700 E WALNUT ST, BLOOMINGTON, IL 61701-3244
(309) 827-8004
Mailing address
700 E WALNUT ST, BLOOMINGTON, IL 61701-3244
(309) 827-8004
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160008716
IL
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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