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Individual

BRYAN S SILLAMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
34827 N 30TH AVE, PHOENIX, AZ 85086-3236
(623) 628-4137
Mailing address
34827 N 30TH AVE, PHOENIX, AZ 85086-3236

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4268
AZ

Other

Enumeration date
03/17/2009
Last updated
03/17/2009
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