Individual
ROBERT WILLIAM WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
14502 GREENVIEW DR, SUITE 408, LAUREL, MD 20708-3287
(301) 362-0114
Mailing address
4740 EVERLEA CT, PRESTON, MD 21655-1569
(210) 632-7748
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A3634
MD
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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