Healthcare Provider Details

I. General information

NPI: 1013445279
Provider Name (Legal Business Name): MICHELE ANTOINETTE PUZIO MSPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 05/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7460 LANCASTER PIKE STE 8
HOCKESSIN DE
19707-9276
US

IV. Provider business mailing address

185 THOMPSON DR
HOCKESSIN DE
19707-1913
US

V. Phone/Fax

Practice location:
  • Phone: 302-234-4045
  • Fax: 302-234-4046
Mailing address:
  • Phone: 302-635-7079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0001655
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: