Individual
MR. REX DACILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
42 HAWK RD, LAWRENCEVILLE, NJ 08648-1353
(609) 919-1930
Mailing address
42 HAWK RD, LAWRENCEVILLE, NJ 08648-1353
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
PTA40QB00242200
NJ
225200000X
Physical Therapy Assistant
Primary
TEI002499
PA
Other
Enumeration date
12/02/2007
Last updated
08/03/2014
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