Cornelius Liclic, LPTA | |
7501 Heritage Village Plz, Gainesville, VA 20155-3078 | |
(210) 542-5623 | |
Not Available |
Full Name | Cornelius Liclic |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 7501 Heritage Village Plz, Gainesville, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417686494 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 2306604819 (Virginia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Cornelius Liclic, LPTA 12507 Quarterhorse Ln, Woodbridge, VA 22192-6371 Ph: () - | Cornelius Liclic, LPTA 7501 Heritage Village Plz, Gainesville, VA 20155-3078 Ph: (210) 542-5623 |
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