Healthcare Provider Details

I. General information

NPI: 1922329531
Provider Name (Legal Business Name): ERIN AUTHIER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/17/2010
Last Update Date: 06/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 INTERNATIONAL PKWY
LAKE MARY FL
32746-5061
US

IV. Provider business mailing address

6487 STATE HIGHWAY 151
MINGO JUNCTION OH
43938-7935
US

V. Phone/Fax

Practice location:
  • Phone: 800-806-6026
  • Fax:
Mailing address:
  • Phone: 740-424-4313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberTEI002562
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: