Individual
ANTOINE DELEUZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
144 FLUG AVE, INDIALANTIC, FL 32903-2942
(407) 701-9228
Mailing address
144 FLUG AVE, INDIALANTIC, FL 32903-2942
(407) 701-9228
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 12581
FL
Other
Enumeration date
11/11/2014
Last updated
11/11/2014
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