Individual
GLINDA WHITTAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA, LMT
Contact information
Practice address
4230 LAFAYETTE ST STE C, MARIANNA, FL 32446-8231
(850) 526-1093
Mailing address
17352 MAIN ST N, BLOUNTSTOWN, FL 32424-1763
(850) 674-7639
(850) 674-4305
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA25146
FL
225700000X
Massage Therapist
MA30601
FL
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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