Individual
ANGELA GAYLORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6500 CRILL AVE STE 3, PALATKA, FL 32177-6807
(386) 325-1119
Mailing address
148 MILLER SQ, INTERLACHEN, FL 32148-4126
(386) 684-0905
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA19349
FL
Other
Enumeration date
09/30/2006
Last updated
07/08/2007
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