MEDICARE: JUDY MICHALSKI-KUEHNEL 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	PT22853	FL

General Provider Information

NPI Number	:	1578858809
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUDY MICHALSKI-KUEHNEL PT

Provider Business Mailing Address
First Line	:	PO BOX 95004
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33804-5004
Country	:	US
Telephone Number	:	863-680-7000
Fax Number	:	866-264-8519

Provider Business Practice Location Address
First Line	:	2190 E COUNTY ROAD 540A
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33813-3740
Country	:	US
Telephone Number	:	863-607-3738
Fax Number	:	866-264-8519

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

Provider Enumeration Date	:	06/15/2011
Last Update Date	:	10/24/2017

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