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MR. EDWIN LU BALLADA DPT
>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersRegistrant NPI Number: 1891828927
Individual Registrant:MR. EDWIN LU BALLADA DPT
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
411 W WOODWARD AVE EUSTIS, FL 32726-4554 US
Tel: 352-357-3565 Fax: --
Tel: 352-357-3565 Fax: --
Contact information for business:
411 W WOODWARD AVE EUSTIS, FL 32726-4554 US
Tel: 352-357-3565 Fax: --
Tel: 352-357-3565 Fax: --
Registration Information:
NPI: 1891828927
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist | FL | 23177 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
