Individual
DEBORAH NOETHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
928 MAR WALT DR, SUITE 104, FORT WALTON BEACH, FL 32547
(850) 863-4747
Mailing address
133 LAKE LORRAINE CIR, SHALIMAR, FL 32579-1619
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA001909
LICENSE#
FL
Enumeration date
08/31/2006
Last updated
07/08/2007
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