Individual
BRYAN CASTILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14715 MAYBERRY DR, PORT SHELDON, MI 49460-4946
(231) 633-4450
Mailing address
14715 MAYBERRY DR, WEST OLIVE, MI 49460-8423
(231) 633-4450
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013710
MI
Other
Enumeration date
11/30/2018
Last updated
11/30/2018
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