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1912140369
CANDICE LEE BUSTOS
SCRANTON, PA
NPI
1912140369
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: PA PT017521)
Enumeration Date
2009-04-15
Last Update Date
2009-04-15
Business Address
-- CANDICE LEE BUSTOS DPT
401 PENN AVE
SCRANTON, PA 18503-1213
Phone number: 814-506-8212
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Mailing Address
-- CANDICE LEE BUSTOS DPT
1001 WESTWOOD DR
SOUTH ABINGTON TOWNSHIP, PA 18411-8603
Phone number: 814-506-8212
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