Individual
DOUGLAS VANACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
17419 BRIDGE HILL CT, TAMPA, FL 33647-3599
(813) 907-7879
(813) 994-3080
Mailing address
13601 BRUCE B DOWNS BLVD, SUITE 110, TAMPA, FL 33613-4657
(813) 907-7879
(813) 994-3080
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT7651
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT7651
PT7651
FL
Enumeration date
11/16/2011
Last updated
11/16/2011
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