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1306014121
FREDERICK BACA
PUEBLO, CO
NPI
1306014121
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
Enumeration Date
2008-02-14
Last Update Date
2008-02-14
Business Address
-- FREDERICK BACA PTA
1008 MINNEQUA AVE
PUEBLO, CO 81004
Phone number: 719-560-5417
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Mailing Address
-- FREDERICK BACA PTA
DEPARTMENT 1188
DENVER, CO 80291-1188
Phone number: 303-486-5500
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