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Individual

ANGELA MACCOLLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
3861 MISSION AVE STE B25, OCEANSIDE, CA 92058-1817
(760) 655-1322
Mailing address
1235 RIO WAY, VISTA, CA 92081-6317
(760) 707-9655

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50786
CA

Other

Enumeration date
11/03/2020
Last updated
11/03/2020
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