Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | PTA20299 | FL |
NPI | 1013305853 |
---|---|
Provider Name | Samantha Stryke |
First Address | Ocala, FL 34471-3333 |
Second Address | Ocala, FL 34471-3333 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/01/2015 |
Last Update Date | 01/01/2015 |