Individual
MR. KEITH HNILICKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LATC
Contact information
Practice address
9880 GOOD LUCK RD, LANHAM, MD 20706-3423
(301) 918-8600
Mailing address
4517 YORKSHIRE DR, ELLICOTT CITY, MD 21043-6559
(443) 799-1109
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0000370
MD
Other
Enumeration date
07/24/2014
Last updated
08/22/2014
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