Search › Virginia › 343900000X
Juan Illesca
NPI 1447606991 · on the registry since 2016 · sole proprietor
Practice
- Address
- 22054 Shaw Rd
Ste H
Sterling, VA 20164 - Phone
- (571) 268-9858
- Fax
- (571) 313-1147
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- VA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-05-13
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia