Individual
EMILY BACALAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12631 E 17TH AVE RM 3001B, AURORA, CO 80045-2527
(303) 724-1965
Mailing address
12631 E 17TH AVE RM 3001B205, AURORA, CO 80045-2527
(303) 724-1965
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TL0008590
CO
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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