Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | PT10470 | FL |
NPI | 1134275241 |
---|---|
Provider Name | Ms. Margaret Ann Reilly |
First Address | Odessa, FL 33556-5720 |
Second Address | St Petersburg, FL 33701-4816 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2007 |
Last Update Date | 08/07/2007 |