MEDICARE: WENDY WHITFIELD PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT 26817	FL

General Provider Information

NPI Number	:	1538443353
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY WHITFIELD PT

Provider Business Mailing Address
First Line	:	3425 EXECUTIVE PKWY
Second Line	:	SUITE 128
City	:	TOLEDO
State	:	OH
Zip	:	43606-1326
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1852 SW BARNETT WAY
Second Line	:	SUITE 101
City	:	LAKE CITY
State	:	FL
Zip	:	32025-6953
Country	:	US
Telephone Number	:	386-752-7332
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2011
Last Update Date	:	09/29/2011

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