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Individual

NICHOLAS RYAN HYATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
600 W NORTH BLVD, SUITE D, LEESBURG, FL 34748-5063
(352) 728-6636
(352) 787-4522
Mailing address
600 W NORTH BLVD, SUITE D, LEESBURG, FL 34748-5063
(352) 728-6636
(352) 787-4522

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24859
FL

Other

Enumeration date
11/17/2014
Last updated
11/17/2014
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