Individual
BRYAN JAMES BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
5454 N HAVERHILL RD, WEST PALM BEACH, FL 33407-3006
(713) 376-6999
Mailing address
5454 N HAVERHILL RD, WEST PALM BEACH, FL 33407-3006
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL4461
FL
2255A2300X
Athletic Trainer
Primary
AT5461
TX
2255A2300X
Athletic Trainer
AT667
NM
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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