Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 31581 | FL |
NPI | 1689196214 |
---|---|
Provider Name | Marissa Littman |
First Address | Orlando, FL 32825-3826 |
Second Address | Celebration, FL 34747-4970 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2017 |
Last Update Date | 14/07/2017 |