Healthcare Provider Details

I. General information

NPI: 1629256052
Provider Name (Legal Business Name): PAULA KATHERINE HULIN P.T. D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2008
Last Update Date: 08/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20733 NORTH BROAD ST.
CARLINVILLE IL
62626-3710
US

IV. Provider business mailing address

20733 NORTH BROAD ST.
CARLINVILLE IL
62626-3710
US

V. Phone/Fax

Practice location:
  • Phone: 217-854-3839
  • Fax: 217-854-9820
Mailing address:
  • Phone: 217-854-3839
  • Fax: 217-854-9820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070012524
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.012524
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: