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Individual

LARAMIE RAE TESILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
880 S TELSHOR BLVD STE 202, LAS CRUCES, NM 88011-8601
(575) 339-1066
Mailing address
625 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2395
(616) 356-5000
(616) 356-5001

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2024-0227
NM

Other

Enumeration date
08/26/2024
Last updated
08/26/2024
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