Individual
MRS. DEMITRIS MARLENA TILLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
576 JEFFERSON AVE, FORT EUSTIS, VA 23604-1602
(757) 314-7666
Mailing address
70 SHANNON DR, NEWPORT NEWS, VA 23608-3125
(757) 234-6328
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
07/09/2008
Last updated
07/09/2008
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