Individual
PATRICIA LYNN ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1727 LILABERRY LANE, NICEVILLE, FL 32578-8742
(850) 687-4167
(850) 807-6677
Mailing address
1727 LILABERRY LANE, NICEVILLE, FL 32578-8742
(850) 897-1805
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 24137
FL
Other
Enumeration date
08/05/2008
Last updated
02/01/2011
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