Individual
MRS. COLLEEN LYNN BEVILACQUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
11 BRUCE ST, SCOTIA, NY 12302-2312
(518) 391-3334
Mailing address
11 BRUCE ST, SCOTIA, NY 12302-2312
(518) 391-3334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
022129
NY
Other
Enumeration date
01/23/2011
Last updated
09/14/2011
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