Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TE1100X | Exercise & Sports Psychologist | FL | |
Y | 226300000X | Kinesiotherapist | FL |
NPI | 1063058857 |
---|---|
Provider Name | Rees Cattermole |
First Address | Englewood, FL 34224-8110 |
Second Address | Englewood, FL 34224-8110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2019 |
Last Update Date | 27/11/2019 |