Individual
MR. CORDERO SHAWN TOLBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4693 BISON ST, BOCA RATON, FL 33428-4135
(561) 541-8621
Mailing address
4693 BISON ST, BOCA RATON, FL 33428-4135
(561) 541-8621
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20819
FL
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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