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NPI 1407811912

NPI 1407811912 : LIZA CORZO HOLMAN PT : LAKE WORTH, FL

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General NPI Number Information
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    NPI Number           |    1407811912
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    Entity Type          |    Individual 
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    Provider Name        |    LIZA CORZO HOLMAN PT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/18/2006
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    Last Update Date     |    04/28/2016
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Provider Practice Location Address
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    Address Line         |    3230 LAKE WORTH RD. SUITE C
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    City                 |    LAKE WORTH
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    State                |    FL
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    Zip                  |    33461
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    Country              |    US
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    Telephone            |    561-968-7788
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3230 LAKE WORTH RD. SUITE C
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    City                 |    LAKE WORTH
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    State                |    FL
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    Zip                  |    33461
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    Country              |    US
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    Telephone            |    561-968-7788
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    PT18636
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    License Number State |    FL
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