Individual
DESTANIE ANN WHITTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
355 CURRANT TRCE, MARY ESTHER, FL 32569-2188
(918) 868-7834
Mailing address
355 CURRANT TRCE, MARY ESTHER, FL 32569-2188
(918) 868-7834
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA31087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA31087
FLORIDA LICENSE NUMBER
FL
Enumeration date
05/04/2021
Last updated
05/04/2021
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