Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA20493 | FL |
NPI | 1003337833 |
---|---|
Provider Name | Mrs. April Blomqvist |
First Address | Palm Beach Gardens, FL 33410-1546 |
Second Address | West Palm Beach, FL 33406-5640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2017 |
Last Update Date | 01/07/2017 |