Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA26806 | FL |
NPI | 1013464130 |
---|---|
Provider Name | Jacqueline Neff |
First Address | Sanford, FL 32773-5953 |
Second Address | Sanford, FL 32773-5953 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2016 |
Last Update Date | 09/09/2016 |