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General NPI Number Information
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NPI Number | 1548808116
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Entity Type | Individual
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Provider Name | JASON MICHAEL VOLLWEILER PTA
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Gender | Male
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 901 45TH ST KIMMEL BLDG
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City | WEST PALM BEACH
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State | FL
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Zip | 33407
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Country | US
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Telephone | 561-844-5255
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Fax |
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Provider Business Mailing Address
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Address Line | 115 LANDINGS BLVD
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City | GREENACRES
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State | FL
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Zip | 33413-2027
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Country | US
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Telephone | 561-722-2288
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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