Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA18388 | FL |
NPI | 1013243427 |
---|---|
Provider Name | Jennifer Elizabeth Mcgrath |
First Address | Dundee, FL 33838-4432 |
Second Address | Dundee, FL 33838-4432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2009 |
Last Update Date | 20/10/2009 |