Individual
ERICA ILLIUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1811 E APACHE BLVD. #3024, TEMPE, AZ 85281
(916) 365-3600
Mailing address
1811 E APACHE BLVD. #3024, TEMPE, AZ 85281
(916) 365-3600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1321
AZ
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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