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1255801239
WADE MARTIN TILLOTSON
SAN LUIS OBISPO, CA
NPI
1255801239
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: CA 33508)
Enumeration Date
2018-12-03
Last Update Date
2018-12-03
Business Address
MR. WADE MARTIN TILLOTSON PT
1422 MONTEREY ST STE C102
SAN LUIS OBISPO, CA 93401-2954
Phone number: 805-543-5100
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Mailing Address
MR. WADE MARTIN TILLOTSON PT
1422 MONTEREY ST STE C102
SAN LUIS OBISPO, CA 93401-2954
Phone number: 805-543-5100
Copy
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