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Individual

ERIC KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
5535 S WILLIAMSON BLVD, SUITE 774, PORT ORANGE, FL 32128-8311
(888) 265-2680
Mailing address
11661 JULIEN RD, GRACEY, KY 42232-9203
(270) 348-7631

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2125460
TX
225200000X
Physical Therapy Assistant
A00832
KY

Other

Enumeration date
02/23/2017
Last updated
02/23/2017
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