Individual
DYLAN JAMES MCILLECE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
500 FOOTHILL DR, SALT LAKE CITY, UT 84148-0001
(801) 582-1565
Mailing address
1172 E KENSINGTON AVE, SALT LAKE CITY, UT 84105-2536
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12837723-2401
UT
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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