Individual
ERIC JOSEPH SUPNET SEVIDAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3290 EXECUTIVE CENTER II, CAMBRIDGE HEALTHCARE NORTH RIDGE, ELLICOTT, MD 21043
(410) 750-9006
Mailing address
172 MANZANITA PL, HERCULES, CA 94547-1161
(510) 245-1252
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NC
Other
Enumeration date
12/27/2007
Last updated
12/27/2007
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