Individual
XAVIER COLLAZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
11100
TN
225100000X
Physical Therapist
292550
CA
225200000X
Physical Therapy Assistant
Primary
CP001369T
NC
Other
Enumeration date
09/13/2017
Last updated
03/13/2020
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