Individual
MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
10100 HILLVEIW DR., PENSACOLA, FL 32514
(850) 478-5153
Mailing address
413 CANTERBURY LN, GULF BREEZE, FL 32561-4416
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21818
FL
Other
Enumeration date
11/19/2009
Last updated
11/19/2009
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