Individual
LULIE RADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
807 N TYNDALL PKWY, PANAMA CITY, FL 32404-9495
(850) 763-0505
Mailing address
807 N TYNDALL PKWY, PANAMA CITY, FL 32404-9495
(850) 763-0505
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
PT 23560
FL
2251X0800X
Orthopedic Physical Therapist
Primary
PT 23560
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K4001
MEDICARE PART B
FL
Enumeration date
09/12/2007
Last updated
09/12/2007
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