| NPI | 1841553641 |
|---|---|
| Former Name | JACQUELINE R. BACCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT022060) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2016-01-05 |