Individual
MONICA MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2613 S 29TH ST, FORT PIERCE, FL 34981-5558
(772) 359-1475
Mailing address
2613 S 29TH ST, FORT PIERCE, FL 34981-5558
(772) 359-1475
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A4541
NC
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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