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1336804731
JOSEPH ANTOHNY ILLIDGE
ALBUQUERQUE, NM
NPI
1336804731
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2021-11-01
Last Update Date
2021-11-01
Business Address
JOSEPH ANTOHNY ILLIDGE
3405 CHERAZ RD NE
ALBUQUERQUE, NM 87111-4638
Phone number: 703-398-5019
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Mailing Address
JOSEPH ANTOHNY ILLIDGE
3405 CHERAZ RD NE
ALBUQUERQUE, NM 87111-4638
Phone number: 703-398-5019
Copy
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