Individual
MICHAEL JOHN HAWKINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1525 HERBERT ST, PORT ORANGE, FL 32129-6106
(386) 774-4404
Mailing address
1525 HERBERT ST, PORT ORANGE, FL 32129-6106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA21140
FL
Other
Enumeration date
05/10/2016
Last updated
05/10/2016
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