Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT0022677 | FL |
NPI | 1043246606 |
---|---|
Provider Name | Mr. Erik A Bleeker |
First Address | Ft Lauderdale, FL 33308-1005 |
Second Address | Boynton Beach, FL 33435-7944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2006 |
Last Update Date | 22/10/2008 |