MEDICARE: MS. CAROL LYNN MCHUGH P.T.

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 25133	FL

General Provider Information

NPI Number	:	1962731448
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CAROL LYNN MCHUGH P.T.

Provider Business Mailing Address
First Line	:	1200 SW 11TH WAY
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-6255
Country	:	US
Telephone Number	:	248-496-8838
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 SW 11TH WAY
Second Line	:
City	:	DEERFIELD BEACH
State	:	FL
Zip	:	33441-6255
Country	:	US
Telephone Number	:	248-496-8838
Fax Number	:

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

Provider Enumeration Date	:	12/14/2009
Last Update Date	:	12/14/2009

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