CORNELIUS LICLIC

GAINESVILLE, VA
NPI1417686494
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225100000X Physical Therapist
(Licence: VA  2306604819)
Enumeration Date2022-06-06
Last Update Date2022-06-06
Business Address
CORNELIUS LICLIC LPTA
7501 HERITAGE VILLAGE PLZ
GAINESVILLE, VA 20155-3078
Phone number: 210-542-5623
Mailing Address
CORNELIUS LICLIC LPTA
12507 QUARTERHORSE LN
WOODBRIDGE, VA 22192-6371
Phone number:
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