Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | FL |
NPI | 1407439201 |
---|---|
Provider Name | Alyssa Anne Verwoert |
First Address | Oviedo, FL 32765 |
Second Address | Oviedo, FL 32765-3276 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2021 |
Last Update Date | 30/04/2021 |