Individual
CASEY DEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
162 W ROBERTSON ST, BRANDON, FL 33511-5112
(813) 681-6100
Mailing address
1056 BRIDLEWOOD WAY, BRANDON, FL 33511-6249
(352) 410-0019
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25788
FL
Other
Enumeration date
09/23/2015
Last updated
09/23/2015
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