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General NPI Number Information
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NPI Number | 1518254838
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Entity Type | Individual
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Provider Name | JODY PAITRA MOHLE CORR PT DPT
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 12/02/2024
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Provider Practice Location Address
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Address Line | 2059 ALTAMONT AVE STE 105
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City | FORT MYERS
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State | FL
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Zip | 33901
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Country | US
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Telephone | 239-400-5639
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Fax | 866-835-2456
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Provider Business Mailing Address
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Address Line | 2059 ALTAMONT AVE STE 105
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City | FORT MYERS
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State | FL
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Zip | 33901-3281
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Country | US
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Telephone | 239-400-5639
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Fax | 866-835-2456
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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 | PT29036
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License Number State | FL
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