Individual
MRS. MICHELLE RENEE NEWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1703 MAGNOLIA AVE LOT F6, SOUTH DAYTONA, FL 32119-1725
(386) 756-0305
Mailing address
1703 MAGNOLIA AVE LOT F6, SOUTH DAYTONA, FL 32119-1725
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PTA10855
FL
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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