Individual
MR. BENJAMIN OGALESCO ILAGAN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
200 CLEAR VIEW CT, CHURCHVILLE, MD 21028-1606
(410) 734-4818
Mailing address
200 CLEAR VIEW CT, CHURCHVILLE, MD 21028-1606
(410) 734-4818
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
18395
MD
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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