Individual
ELYDE MARIT CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8819 W VICTORIA AVE # 110, KENNEWICK, WA 99336-7193
(509) 783-1851
Mailing address
8437 LENNOX ST, WEST RICHLAND, WA 99353-5533
(509) 303-0434
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
60658597
WA
Other
Enumeration date
10/11/2023
Last updated
10/11/2023
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