Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 070021547 | IL |
NPI | 1003282443 |
---|---|
Provider Name | Adam Schuler |
First Address | Streator, IL 61364-2370 |
Second Address | Streator, IL 61364-2370 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2015 |
Last Update Date | 24/09/2015 |