Individual
ILYN BACOLOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
969 PARK ST, ATTLEBORO, MA 02703-5115
(508) 222-4182
Mailing address
297 HIGH HILL RD, SWANSEA, MA 02777-5078
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N0717506814-8
HPSO
MA
Enumeration date
08/31/2022
Last updated
08/31/2022
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