Individual
MRS. MARITA ILLESCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
235 E HIGH ST, MOORESVILLE, IN 46158-1639
(317) 371-8180
(833) 925-2447
Mailing address
235 E HIGH ST, MOORESVILLE, IN 46158-1639
(317) 371-8180
(833) 925-2447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05013849A
IN
Other
Enumeration date
09/12/2024
Last updated
09/12/2024
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