Individual
MRS. ANTOINETTE MARIA ELISABETH PULVER
Active
Individual
MRS. ANTOINETTE MARIA ELISABETH PULVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
P12209
NC
2251P0200X
Pediatric Physical Therapist
Primary
PT 24860
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407834021
GROUP NPI
FL
01
—
592984541
GROUP TAX ID
FL
01
—
Y905L
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/05/2009
Last updated
08/05/2009
Update your record
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