Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | 10901 | NC |
Y | 2251X0800X | Physical Therapist - Orthopedic | PT25476 | FL |
NPI | 1003011107 |
---|---|
Provider Name | Mr. Philip L Standhart |
First Address | Naples, FL 34112-6201 |
Second Address | Naples, FL 34112-6201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2007 |
Last Update Date | 14/10/2010 |