Individual
AUTUMN ORVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4411 N HABANA AVE, TAMPA, FL 33614-7211
(813) 872-2771
Mailing address
28712 REVARO LN, WESLEY CHAPEL, FL 33543-7618
(941) 962-4190
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA31350
FL
Other
Enumeration date
08/18/2021
Last updated
08/18/2021
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