Individual
CARY MATTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1104 N MAIN ST, BUSHNELL, FL 33513-5045
(352) 568-8777
Mailing address
1104 N MAIN ST, BUSHNELL, FL 33513-5045
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1579
FL
Other
Enumeration date
11/17/2015
Last updated
11/17/2015
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