Individual
CANDICE HULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4166 TAMIAMI TRL STE A, PORT CHARLOTTE, FL 33952-9255
(941) 766-1110
(941) 766-1190
Mailing address
3041 ALICEVILLE RD, NORTH PORT, FL 34288-0836
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24209
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA24209
PTA LICSENCE
FL
Enumeration date
06/05/2017
Last updated
06/05/2017
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