Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT33802 | FL |
NPI | 1295214575 |
---|---|
Provider Name | Dr. Christopher Irby Atkinson |
First Address | Orlando, FL 32817-3378 |
Second Address | Merritt Island, FL 32953-5034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2018 |
Last Update Date | 08/08/2018 |