Individual
PETER G SILLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3645 N BEACH ST, FORT WORTH, TX 76137-3242
(214) 945-6701
Mailing address
802 SHADOW GLEN DR, SOUTHLAKE, TX 76092-7236
(214) 945-6701
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2109536
TX
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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