Individual
ELAINE ROSEMARY MACCOLLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8140 BAYHAVEN DR, SEMINOLE, FL 33776-3321
(727) 644-0403
(727) 398-1372
Mailing address
8140 BAYHAVEN DR, SEMINOLE, FL 33776-3321
(727) 644-0403
(727) 398-1372
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2644
FL
Other
Enumeration date
01/14/2020
Last updated
01/14/2020
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