Individual
MR. ANTHONY PETER BASTOLLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
705 W STATE ROAD 434, LONGWOOD, FL 32750-4907
(407) 831-6801
Mailing address
426 OAK HAVEN DR, ALTAMONTE SPRINGS, FL 32701-6318
(407) 331-0986
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PT20901
FL
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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