Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | ||
N | 2251N0400X | Physical Therapist - Neurology |
NPI | 1215403118 |
---|---|
Provider Name | Colin Hulls |
First Address | Chicago, IL 60677-6351 |
Second Address | Louisville, KY 40207-4744 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2018 |
Last Update Date | 19/01/2021 |