Ian James Bacolod, P.T. Valid NPI

Individual provider · Physical Therapist · Jefferson City, MO

NPI

1093066532

Type

Individual (Type 1)

Primary specialty

Physical Therapist

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

225100000X

License number

100687 (MO)

Sex

Male

Sole proprietor

Yes

Enumerated

2012-09-24

Last updated

2012-09-24