Individual
ANISSA CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
347 S GLADSTONE AVE, AURORA, IL 60506-4877
(619) 701-7035
Mailing address
1025 PETERLYNN DR, SAN DIEGO, CA 92154-2558
(619) 701-7035
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/20/2018
Last updated
06/10/2019
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