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Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist

Provider NPI: 1649376690

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
11375 BIG BEND RD  RIVERVIEW, FL 33579-7183 US
Tel: 813-805-8167  Fax: --

Business Mailing Address:
3903 NORTHDALE BLVD STE 111W TAMPA, FL 33624-1853 US
Tel: 813-381-6778  Fax: 440-815-2120

NPI Information:
NPI: 1649376690
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
N2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
N2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 225100000X





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