Individual
MRS. NICOLE M VAN LEEUWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1419 DENLOW LN, ROYAL PALM BEACH, FL 33411-4013
(561) 762-0637
(561) 357-5884
Mailing address
1419 DENLOW LN, ROYAL PALM BEACH, FL 33411-4013
(561) 762-0637
(561) 357-5884
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 20818
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 20818
AMERICAN PHYSICAL THERAPY ASSOCIATION
FL
Enumeration date
06/24/2008
Last updated
06/24/2008
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