Individual
DEANNA KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2839 SW 87TH DR STE 10, GAINESVILLE, FL 32608-9376
(352) 505-6665
Mailing address
2839 SW 87TH DR STE 10, GAINESVILLE, FL 32608-9376
(352) 505-6665
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29177
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA29177
STATE OF FLORIDA
FL
Enumeration date
02/04/2019
Last updated
02/04/2019
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