Individual
MR. PATRICK DEACHILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
5601 LOCH RAVEN BLVD, RUSSELL MORGAN BUILDING SUITE 405, BALTIMORE, MD 21239-2945
(443) 444-4764
Mailing address
438 E CROSS ST, BALTIMORE, MD 21230-4126
(717) 515-5088
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A0000409
MD
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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