Individual
REBECCA MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1701 PARK AVE, ORANGE PARK, FL 32073-4946
(904) 218-1210
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 19096
FL
Other
Enumeration date
09/24/2007
Last updated
09/24/2007
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