Healthcare Provider Details

I. General information

NPI: 1376061622
Provider Name (Legal Business Name): ARRON TODD OCHELTREE PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2017
Last Update Date: 09/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

498 PALM SPRINGS DR
ALTAMONTE SPRINGS FL
32701-7829
US

IV. Provider business mailing address

2001 GLENRIDGE WAY APT 17
WINTER PARK FL
32792-5427
US

V. Phone/Fax

Practice location:
  • Phone: 407-494-0644
  • Fax:
Mailing address:
  • Phone: 912-977-4443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA27698
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: