Individual
EUGENE PAUL BACOLOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
15204 W COLONIAL DR, WINTER GARDEN, FL 34787-6042
(407) 877-2394
Mailing address
646 W SMITH ST UNIT 349, ORLANDO, FL 32804-5381
(832) 512-0505
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
29471
FL
Other
Enumeration date
09/10/2019
Last updated
09/10/2019
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