Individual
MRS. JULIANNE KUMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA, MT
Contact information
Practice address
4166 TAMIAMI TRAIL, UNIT A, PORT CHARLOTTE, FL 33952
(941) 766-1110
Mailing address
4435 GILLOT BLVD, PORT CHARLOTTE, FL 33981-1719
(941) 830-0893
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PTA20696
FL
225700000X
Massage Therapist
MA83575
FL
Other
Enumeration date
10/31/2016
Last updated
11/16/2016
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