Individual
MR. NOAH WOODBERRY MCDADE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
13000 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4745
(813) 972-2000
Mailing address
15210 AMBERLY DR, APT # 1332, TAMPA, FL 33647-2196
(352) 584-1424
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 19661
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 19661
PTA LICENSE
FL
Enumeration date
06/08/2006
Last updated
07/08/2007
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