Individual
CARLA RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
7720 US HIGHWAY 98 W, SUITE 220, DESTIN, FL 32550-7230
(850) 123-4567
Mailing address
7720 US HIGHWAY 98 W, SUITE 220, DESTIN, FL 32550-7230
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PT 19826
FL
Other
Enumeration date
10/24/2008
Last updated
10/24/2008
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