Individual
EILEEN ENGQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9179 SE 130TH LOOP, SUMMERFIELD, FL 34491-9452
(352) 452-0749
Mailing address
9179 SE 130TH LOOP, SUMMERFIELD, FL 34491-9452
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1634
FL
Other
Enumeration date
01/15/2012
Last updated
01/15/2012
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