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NPI Code Detail

MEDICARE: JOAN KRISTEN MCLOUD PT

MEDICARE: JOAN KRISTEN MCLOUD PT
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 TherapistPT14724FL

General Provider Information

NPI Number : 1144225509
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOAN KRISTEN MCLOUD PT
Provider Business Mailing Address
First Line : 705 WELLS RD STE 300
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-2982
Country : US
Telephone Number : 904-282-6331
Fax Number : 904-619-1080
Provider Business Practice Location Address
First Line : 2700 RIVERSIDE AVE STE 4
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32205-8233
Country : US
Telephone Number : 904-644-8913
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 09/18/2023

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