Individual
WILMAN ANTONIO GRANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4728 HAMPDEN LN, BETHESDA, MD 20814-2910
(240) 481-8248
Mailing address
13145 DAIRYMAID DR, APT 204, GERMANTOWN, MD 20874-2326
(240) 481-8248
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
M03594
MD
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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