Search › Illinois › 2255A2300X
Bryan Domitrz, ATC, LAT
NPI 1871186304 · on the registry since 2021 · sole proprietor
Practice
- Address
- 501 N Parkside Rd
Normal, IL 61761 - Phone
- (309) 557-4402
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-02-16
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois