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General NPI Number Information
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NPI Number | 1700501178
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Entity Type | Individual
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Provider Name | MARSHA R BRIGHT PTA
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Gender | Female
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Dates
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Enumeration Date | 10/07/2022
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Last Update Date | 10/07/2022
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Provider Practice Location Address
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Address Line | 8601 N DAVIS HWY
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City | PENSACOLA
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State | FL
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Zip | 32514-5932
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Country | US
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Telephone | 850-390-8991
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Fax |
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Provider Business Mailing Address
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Address Line | 305 PIN OAK CT
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City | PENSACOLA
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State | FL
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Zip | 32514-7226
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Country | US
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Telephone | 850-393-4289
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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 | PTA13097
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License Number State | FL
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