Individual
AMYE-MARIE GROSS WICHAEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1565 SAXON BLVD, SUITE 301, DELTONA, FL 32725-5876
(386) 851-0901
Mailing address
1200 LEXINGTON GREEN LN, SANFORD, FL 32771-1013
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
29464
FL
Other
Enumeration date
09/29/2014
Last updated
04/01/2016
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