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1093355497
BRADLEY ILLESCAS
SILVER SPRING, MD
NPI
1093355497
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
Enumeration Date
2020-01-14
Last Update Date
2020-01-14
Business Address
Mr. BRADLEY ILLESCAS
12905 LAYHILL RD
SILVER SPRING, MD 20906-3329
Phone number: 240-855-4481
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Mailing Address
Mr. BRADLEY ILLESCAS
12905 LAYHILL RD
SILVER SPRING, MD 20906-3329
Phone number: 240-855-4481
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