Individual
DR. KENNETH TILLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., P.A.
Contact information
Practice address
825 DULANEY VALLEY RD, 2ND FLOOR, TOWSON, MD 21204-1010
(410) 828-4133
(410) 828-4646
Mailing address
825 DULANEY VALLEY RD, 2ND FLOOR, TOWSON, MD 21204-1010
(410) 828-4133
(410) 828-4646
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
00641
MD
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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