Individual
ILA CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5001 OFFICE PARK, ODESSA, TX 79762-4843
(432) 362-1800
Mailing address
3412 SEGUIN, ODESSA, TX 79765-8967
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2048317
TX
225200000X
Physical Therapy Assistant
Primary
2048371
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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