PAUL ALVIN CLAVECILLA

CROWN POINT, IN
NPI1710433008
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2251G0304X Physical Therapist, Geriatrics
(Licence: IL  070020612)
Enumeration Date2016-08-28
Last Update Date2016-08-28
Business Address
-- PAUL ALVIN CLAVECILLA
1099 SOUTH MAIN ST. APT. 314
CROWN POINT, IN 46307
Phone number: 847-942-9143
Mailing Address
-- PAUL ALVIN CLAVECILLA
1099 S MAIN ST APT. 314
CROWN POINT, IN 46307-4851
Phone number: 847-942-9143
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