Individual
MS. DEMETRA ELENI YIANNOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, LMT
Contact information
Practice address
4606 CLYDE MORRIS BLVD STE 1D, PORT ORANGE, FL 32129-7453
(386) 492-2986
Mailing address
724 MARATHON WAY, SOUTH DAYTONA, FL 32119-1920
(904) 563-0221
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA31342
FL
Other
Enumeration date
07/29/2021
Last updated
07/29/2021
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