Individual
ERIC A BUCCELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
369 ELDORADO BLVD UNIT 324, BROOMFIELD, CO 80021-3766
(623) 255-9520
Mailing address
369 ELDORADO BLVD UNIT 324, BROOMFIELD, CO 80021-3766
(623) 255-9520
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA.0014887
CO
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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