Individual
MR. BRYAN R PACILLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
1136 N CHINOWTH ST, VISALIA, CA 93291-4113
(559) 596-7101
(559) 671-0101
Mailing address
1136 N CHINOWTH ST, VISALIA, CA 93291-4113
(559) 671-0101
(559) 590-4301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT22909
CA
2251X0800X
Orthopedic Physical Therapist
PT22909
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT229090
BLUE SHIELD
CA
Enumeration date
12/06/2006
Last updated
10/14/2021
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