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Individual

DEBORAH VONBROCKEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
190 RODEO RD, ORMOND BEACH, FL 32174-7928
(386) 295-4493
(386) 446-7777
Mailing address
190 RODEO RD, ORMOND BEACH, FL 32174-7928
(386) 295-4493
(386) 446-7777

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1155
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTA1155
STATE LICENSE
FL
Enumeration date
08/20/2012
Last updated
08/20/2012
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