Individual
CINDY LYNNE BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
66312 US HIGHWAY 50, FOWLER, CO 81039-9606
(719) 568-0040
Mailing address
66312 US HIGHWAY 50, FOWLER, CO 81039-9606
(719) 568-0040
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1424
CO
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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