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Individual

MR. CHRISTOPHER GINNO LOPEZ BASILLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
14014 MARSH PIKE, HAGERSTOWN, MD 21742-1638
(301) 733-8700
Mailing address
14014 MARSH PIKE, HAGERSTOWN, MD 21742-1638
(301) 733-8700

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
24746
MD

Other

Enumeration date
04/22/2014
Last updated
02/11/2015
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