Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 16315 | FL |
NPI | 1003045584 |
---|---|
Provider Name | Mrs. Trisha Reid |
First Address | Celebration, FL 34747-4660 |
Second Address | Celebration, FL 34747-4660 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2009 |
Last Update Date | 07/07/2009 |