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NPI Code Detail

MEDICARE: JOVANNA ARCHIBALD DPT

MEDICARE: JOVANNA ARCHIBALD DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT38980FL

General Provider Information

NPI Number : 1124413216
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOVANNA ARCHIBALD DPT
Provider Business Mailing Address
First Line : 10319 NIALL DR
Second Line :
City : PENSACOLA
State : FL
Zip : 32526-4555
Country : US
Telephone Number : 850-512-0046
Fax Number :
Provider Business Practice Location Address
First Line : 6002 PROFESSIONAL PKWY STE 140
Second Line :
City : DOUGLASVILLE
State : GA
Zip : 30134-5603
Country : US
Telephone Number : 850-512-0046
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2015
Last Update Date : 06/03/2026

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Directions to “ JOVANNA ARCHIBALD DPT” Practice Location

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