Individual
HEGINIO DE VERA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7 W RIDGELY RD STE A, TIMONIUM, MD 21093-5135
(443) 921-9890
(410) 252-4590
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21738
MD
Other
Enumeration date
07/14/2018
Last updated
07/14/2018
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