MR. Carlos Bastardo

NPI #1417492281 in Plymouth, Indiana

Provider Information

NPI Number
1417492281
Entity Type
Individual
Name
MR. Carlos Bastardo
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Prevention Professional
Enumeration Date
Jan 3, 2017
Last Updated
Jan 3, 2017

Practice Location

Address
11191 SHADYLANE DR
State
Indiana
ZIP Code
46563-8623
Phone
(574) 936-4152

Specialties & Taxonomy Codes

Specialty
Prevention Professional

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