Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT25717 | FL |
NPI | 1063783611 |
---|---|
Provider Name | Dr. Julie Ann Pinson |
First Address | Port Saint Lucie, FL 34984-4456 |
Second Address | Stuart, FL 34994 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2012 |
Last Update Date | 24/01/2012 |