William John Bacon, PTA

NPI #1902168669 in Webster, South Dakota

Provider Information

NPI Number: 1902168669
Entity Type: Individual
Name: William John Bacon, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jun 8, 2012
Last Updated: Jul 15, 2020

Practice Location

Address: 902 E 12TH AVE
City: Webster
State: South Dakota
ZIP Code: 57274-2300
Phone: (956) 451-1907

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X
Physical Therapy Assistant	225200000X	Primary

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