Individual
MARY KNOWLTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
2520 SAND MINE RD, DAVENPORT, FL 33897-3402
(863) 576-1900
(407) 386-7893
Mailing address
510 JAYBEE AVE, DAVENPORT, FL 33897-5452
(321) 297-5345
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA28699
FL
Other
Enumeration date
10/22/2018
Last updated
10/22/2018
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