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NPI Code Detail

MEDICARE: NGUYEN PHUONG LINH HELEN NGUYEN PTA

MEDICARE: NGUYEN PHUONG LINH HELEN NGUYEN PTA
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
1225200000XPhysical Therapy AssistantPTA28881FL

General Provider Information

NPI Number : 1265991848
Entity Type Code : Individual
Provider Name (Legal Business Name) : NGUYEN PHUONG LINH HELEN NGUYEN PTA
Provider Business Mailing Address
First Line : 2600 COMPASS RD
Second Line :
City : GLENVIEW
State : IL
Zip : 60026-8001
Country : US
Telephone Number : 877-787-3430
Fax Number : 847-441-0734
Provider Business Practice Location Address
First Line : 202 AVENUE O NE
Second Line :
City : WINTER HAVEN
State : FL
Zip : 33881-2409
Country : US
Telephone Number : 863-293-3103
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2019
Last Update Date : 03/13/2019

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Directions to “ NGUYEN PHUONG LINH HELEN NGUYEN PTA” Practice Location

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