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NPI Code Detail

MEDICARE: TERESA L FELSTEAD PTA

MEDICARE: TERESA L FELSTEAD PTA
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
1225200000XPhysical Therapy AssistantPTA23468FL

General Provider Information

NPI Number : 1881037638
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERESA L FELSTEAD PTA
Provider Business Mailing Address
First Line : 600 OPP DR
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-4493
Country : US
Telephone Number : 850-301-1935
Fax Number : 850-301-1937
Provider Business Practice Location Address
First Line : 600 OPP DR
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-4493
Country : US
Telephone Number : 850-301-1935
Fax Number : 850-301-1937
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2013
Last Update Date : 04/11/2013

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Directions to “ TERESA L FELSTEAD PTA” Practice Location

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